Individual provider Active NPI

Spencer Margaret Amstrup, DDS

  • General Practice Dentistry
  • Crystal, MN
National Provider Identifier
1023634433
Registry record updated Jul 27, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
D14636 Issued in MN
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

Updated by the provider on Jul 27, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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

LicenseStateTypeSpecialty
DDS-09788IAMDGeneral Practice Dentistry
D14636MNMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Twin Smiles PastSince Aug 1, 2021 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

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.

Verify at the official NPI Registry.