Healthcare Provider Details

I. General information

NPI: 1871428540
Provider Name (Legal Business Name): GILLIAM ENDODONTICS, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/15/2026
Last Update Date: 06/15/2026
Certification Date: 06/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5901 N LIDGERWOOD ST STE 233
SPOKANE WA
99208-1122
US

IV. Provider business mailing address

5901 N LIDGERWOOD ST STE 233
SPOKANE WA
99208-1122
US

V. Phone/Fax

Practice location:
  • Phone: 509-381-5881
  • Fax:
Mailing address:
  • Phone: 509-381-5881
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223E0200X
TaxonomyEndodontics
License Number
License Number State

VIII. Authorized Official

Name: DR. ROBERT NATHAN GILLIAM
Title or Position: OWNER/ENDODONTIST
Credential: DMD
Phone: 509-381-5881