Active NPI
Spencer Margaret Amstrup, DDS
- General Practice Dentistry
- Crystal, MN
National Provider Identifier
1023634433
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- D14636
- Practice address
- 5237 Douglas Dr N
Crystal, MN 55429-3103 - Phone
- (763) 536-1118
- NPI assigned
- Jun 22, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | D14636 | MN | Primary |
| General Practice Dentistry | 1223G0001X | DDS-09788 | IA |
Addresses
Primary practice location
5237 Douglas Dr N
Crystal, MN 55429-3103
Mailing address
6208 Edgemont Blvd N
Brooklyn Park, MN 55428-2655
Phone (612) 275-8035
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DDS-09788 | IA | MD | General Practice Dentistry |
| D14636 | MN | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Twin Smiles | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1592784000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1627344000000",
"number": "1023634433",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6208 EDGEMONT BLVD N",
"city": "BROOKLYN PARK",
"state": "MN",
"postal_code": "554282655",
"telephone_number": "612-275-8035"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5237 DOUGLAS DR N",
"city": "CRYSTAL",
"state": "MN",
"postal_code": "554293103",
"telephone_number": "763-536-1118"
}
],
"practiceLocations": [],
"basic": {
"last_name": "AMSTRUP",
"first_name": "SPENCER",
"middle_name": "MARGARET",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-06-22",
"last_updated": "2021-07-27",
"certification_date": "2021-07-27",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "MN",
"license": "D14636",
"primary": true
},
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "IA",
"license": "DDS-09788",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Crystal, MN
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- Amazing Love Assisted Living LLC
- Amazing Love, LLC (Amazing Love Healthcare Services)
- Brian Ambrosius
- American Volunteers Homes, LLC
- Joyce L Anderson, NP
- Kristi Renee Armstrong
- Susan Ashton
- Aspirations Family Services, LLP
- Aspire Network Inc Professional Service Corporation Aspire Network
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.