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Deactivated NPI 1487727491 Deactivated / Inactive NPI Male Practitioner

Dr. James Walter Soderstrom , DDS

Dentist - General Practice • Aurora, IL

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Dr. James Soderstrom has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date November 16, 2006
NPI Deactivation Date October 02, 2019
Total Practice Duration ~13 Years of Practice (2006 – 2019)

Professional Overview & Biography Verified Profile Summary

Dr. James Soderstrom, DDS was a registered Dentist - General Practice practicing in Aurora, IL. Throughout an active medical career spanning 13 years, Dr. Soderstrom provided care at the practice location at 2121 W GALENA BLVD until profile deactivation on 2019-10-02.

Practice Location & Contact Primary Location

Practice Address

2121 W Galena Blvd

Aurora, IL 605063274

Telephone 6308977839
Associated Practice Facility / Clinic
🏢 Prairie View Orthodontics Facility NPI 1487796629

Specialty Benchmarks & Practice Insights

Comparative analytics for Dentist - General Practice in Aurora, IL

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 18.0 Yrs
Regional Practice Density
70 Specialists

Practicing in Aurora, IL (5581 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Dentist - General Practice Primary Specialty

NUCC Taxonomy Code: 1223G0001X

State License IL 019.014408

A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

11 Historical Events
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Updated Practice Location October 23, 2019

Registered at 2121 W GALENA BLVD, AURORA, IL 605063274 (Tel: 6308977839)

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Updated Business Mailing Address October 23, 2019

Registered at 2121 W GALENA BLVD, AURORA, IL 605063274 (Tel: 6308977839)

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Provider Name / Credentials Updated October 23, 2019

Recorded as JAMES SODERSTROM, D.D.S.

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Medical Taxonomy / Specialty Registered (Primary Specialty) October 23, 2019

Dentist (License #019.014408 in IL)

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NPI Profile Deactivated October 02, 2019

Record deactivated on October 02, 2019

NPI Profile Active July 08, 2007

NPI status registered as active in NPPES database

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Updated Practice Location July 08, 2007

Registered at 2121 W GALENA BLVD, AURORA, IL 605063274 (Tel: 6308977839)

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Updated Business Mailing Address July 08, 2007

Registered at 2121 W GALENA BLVD, AURORA, IL 605063274 (Tel: 6308977839)

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Provider Name / Credentials Updated July 08, 2007

Recorded as JAMES SODERSTROM, D.D.S.

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Medical Taxonomy / Specialty Registered (Primary Specialty) July 08, 2007

Dentist

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Initial NPI Registration & Enumeration November 16, 2006

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1487727491
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: November 16, 2006
Last Update: October 23, 2019
Deactivation Date: October 02, 2019
Sole Proprietor: Yes

Mailing Address

2121 W Galena Blvd

Aurora, IL 605063274

Phone: 6308977839

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.