Herman Sonny Spera III, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

0422491 Issued in NY

Practice address

703 Conklin Rd
Conklin, NY 13748-0198

Phone

(607) 722-5464

Fax

(607) 754-9526

NPI assigned

Jul 31, 2006

Last updated

Jul 9, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Progressive Dental, PLLC

  • General Practice Dentistry
  • Conklin, NY
  • NPI 1821003260
  NPD (past) Authorized official

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

{
    "created_epoch": "1154304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1013923465",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 198",
            "city": "CONKLIN",
            "state": "NY",
            "postal_code": "137480198",
            "telephone_number": "607-722-5464",
            "fax_number": "607-754-9526"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "703 CONKLIN RD",
            "city": "CONKLIN",
            "state": "NY",
            "postal_code": "137480198",
            "telephone_number": "607-722-5464",
            "fax_number": "607-754-9526"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPERA",
        "first_name": "HERMAN",
        "middle_name": "SONNY",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-31",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "0422491",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01245014",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jennifer Long Redmore, DDS
• Cherise Rue, LPN
• Stephen Schilling, MS.,CCC-A
• Annheleen Amy Smith, LMSW
• Bethany Anne Smith
• Susquehanna Valley Central School District
• Joseph John Toman Sr., MSW,LCSW-R
• Nicole Marie Travis, M.A. CCC-SLP
• Keisa Williams

• General Practice Dentistry in Conklin, NY
• Providers in Conklin, NY by specialty
• General Practice Dentistry in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.