Provider Demographics
NPI:1487087516
Name:STEIDLEY, ANDREW RUSSEL (DMD)
Entity type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:RUSSEL
Last Name:STEIDLEY
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:775 HOLLAND AVE
Mailing Address - Street 2:SUITE #202
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99218
Mailing Address - Country:US
Mailing Address - Phone:315-921-5258
Mailing Address - Fax:206-682-0673
Practice Address - Street 1:775 HOLLAND AVE
Practice Address - Street 2:SUITE #202
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99218
Practice Address - Country:US
Practice Address - Phone:509-468-7744
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-13
Last Update Date:2024-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORD10325122300000X, 1223E0200X
UT8749417-9921122300000X, 1223E0200X
WADE607928831223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics
No122300000XDental ProvidersDentist