Shawn Michael Spoden, D.D.S.

Primary specialty

DentistTaxonomy code 122300000X

License

D12591 Issued in MN

Practice address

3015 Highway 29 S
Alexandria, MN 56308-3486

Phone

(320) 763-5052

Fax

(320) 763-5053

NPI assigned

Jul 8, 2008

Last updated

Oct 1, 2012By 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

Medicare fee-for-service enrollment

Enrolled in MN

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1215475200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1349049600000",
    "number": "1023271236",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3015 HIGHWAY 29 S",
            "city": "ALEXANDRIA",
            "state": "MN",
            "postal_code": "563083486",
            "telephone_number": "320-763-5052",
            "fax_number": "320-763-5053"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3015 HIGHWAY 29 S",
            "city": "ALEXANDRIA",
            "state": "MN",
            "postal_code": "563083486",
            "telephone_number": "320-763-5052",
            "fax_number": "320-763-5053"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPODEN",
        "first_name": "SHAWN",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-07-08",
        "last_updated": "2012-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MN",
            "license": "D12591",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Victoria Soltis
• Steven James Solum, M.D.
• James Brian Spaeth, PA-C
• Mark Reid Spanbauer, M.D.
• Andrea Speckmier
• Sarah Jayne Sprengeler, M.D.
• Rebecca Sprenger
• St. Cloud Hospital (CentraCare Kidney Program - Alexandria Dialysis)
• St. Cloud Vamc
• Scott Patrick Stadsklev, DDS

• Dentist in Alexandria, MN
• Providers in Alexandria, MN by specialty
• Dentist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2012; 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.