Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Shadle Smile Source PLLC

Organization Dental Clinic/Center · NPI 1154083822

Shadle Smile Source PLLC is a Dental Clinic/Center in Spokane, Washington. Registered with an NPI since 2021.

In the registry since
2021
What do these letters mean?
PLLC — Professional limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

4610 N Ash St Ste 2O1
Spokane, WA 99205-1482
Phone: (509) 325-4313
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Dental Clinic/Center (primary) Taxonomy 261QD0000X

Record details

NPI number1154083822
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Timothy Casey — President · (509) 280-0002
NPI enumeratedOctober 11, 2021
Last updated in NPPESOctober 11, 2021
Certification dateOctober 11, 2021
Mailing address2513 N Chase Ln, Liberty Lake, WA 99019-7533

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