Spencer Antoine Taylor, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

DN28242 Issued in FL

Practice address

5285 Commerce St
Jay, FL 32565-1179

Phone

(850) 675-8545

NPI assigned

Jun 21, 2023

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Jimmie D Lassiter DMD LLC

  • General Practice Dentistry
  • Jay, FL
  • NPI 1932882552
  NPD

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

{
    "created_epoch": "1687305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687305600000",
    "number": "1083399489",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7675 GUMBO AVE",
            "city": "PACE",
            "state": "FL",
            "postal_code": "325719853",
            "telephone_number": "850-602-5676"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5285 COMMERCE ST",
            "city": "JAY",
            "state": "FL",
            "postal_code": "325651179",
            "telephone_number": "850-675-8545"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAYLOR",
        "first_name": "SPENCER",
        "middle_name": "ANTOINE",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-06-21",
        "last_updated": "2023-06-21",
        "certification_date": "2023-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN28242",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amy Simonetta
• Cleatious David Smith, MD
• David Garrett Smith, PHARM. D
• John-Stewart Michael Smith, MD
• Kelsie Stewart
• The Terrace at Ivey Acres of Jay
• Tri-City Home Medical, Inc.
• Maren Vanatta, OT
• Elizabeth Anne Whitfield
• Erin Marie Willoughby, MRC, CAP

• Dentist in Jay, FL
• Providers in Jay, FL by specialty
• Dentist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2023; 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.