Spruce Dental

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

SPRUCE DENTAL

Practice address

76 Spruce St
Cedarhurst, NY 11516-2018

Phone

(515) 295-3826

NPI assigned

Oct 31, 2018

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Allon Waltuch, DDS

Title

Dentist

Phone

(515) 295-3826

Specialties & licenses 1

Addresses

Other names 1

• Advanced Implant Dentistry and Oral Restoration Doing business as

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1540944000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1540944000000",
    "number": "1013484682",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "76 SPRUCE ST",
            "city": "CEDARHURST",
            "state": "NY",
            "postal_code": "115162018",
            "telephone_number": "515-295-3826"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "76 SPRUCE ST",
            "city": "CEDARHURST",
            "state": "NY",
            "postal_code": "115162018",
            "telephone_number": "515-295-3826"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPRUCE DENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-10-31",
        "last_updated": "2018-10-31",
        "status": "A",
        "authorized_official_last_name": "WALTUCH",
        "authorized_official_first_name": "ALLON",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "515-295-3826",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Advanced Implant Dentistry and Oral Restoration",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Leah Lillian Spiegel, MA CCC-SLP
• Spine Sports & Rehabilitation Medicine, P.C.
• Celia Rachel Sporer
• Yocheved S Sprecher
• Spring Autism Kansas LLC
• Spruce RX, Inc.
• Debra Anne Staiman Fliegelman, OTR/L
• Michele Stein
• Rachael Stein, PA
• Robert Alan Stein, DPM

• Dental Clinic/Center in Cedarhurst, NY
• Providers in Cedarhurst, NY by specialty
• Dental Clinic/Center in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.