Active NPI
Roger J Spott, D.D.S.
- Endodontics
- Pembroke Pines, FL
National Provider Identifier
1063452134
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Endodontics
- License
- DN 4852
- Practice address
- 6805 Pembroke Rd
Pembroke Pines, FL 33023-2620 - Phone
- (954) 989-6950
- NPI assigned
- Jun 7, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Endodontics | 1223E0200X | DN 4852 | FL | Primary |
Addresses
Primary practice location
6805 Pembroke Rd
Pembroke Pines, FL 33023-2620
Mailing address
7315 Valencia Dr
Boca Raton, FL 33433-7407
Phone (561) 488-1862
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160223000281 | FL | Order and Referring Only - Other (Physician) | 0547565996 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DN 4852 | FL | MD | Endodontist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1149638400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1715558400000",
"number": "1063452134",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7315 VALENCIA DR",
"city": "BOCA RATON",
"state": "FL",
"postal_code": "334337407",
"telephone_number": "561-488-1862"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6805 PEMBROKE RD",
"city": "PEMBROKE PINES",
"state": "FL",
"postal_code": "330232620",
"telephone_number": "954-989-6950"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SPOTT",
"first_name": "ROGER",
"middle_name": "J",
"credential": "D.D.S.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-06-07",
"last_updated": "2024-05-13",
"certification_date": "2024-05-13",
"status": "A"
},
"taxonomies": [
{
"code": "1223E0200X",
"taxonomy_group": "",
"desc": "Dentist, Endodontics",
"state": "FL",
"license": "DN 4852",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Pembroke Pines, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2024; 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.