Coleman Jay Spector, DDS

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

021.001732019.023916 Issued in IL

Practice address

1014 W. Belmont Avenue
Chicago, IL 60657

Phone

(773) 472-5235

Fax

(773) 472-6321

NPI assigned

Mar 16, 2007

Sex

Male

Sole proprietor

Yes

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

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.

• A Wulfsohn DMD PC

  • Dental Clinic/Center
  • Chicago, IL
  • NPI 1679140321
  NPD (past)
• Lake View Dental Associates, PC

  • General Practice Dentistry
  • Chicago, IL
  • NPI 1518309152
  NPD (past)

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

{
    "created_epoch": "1174003200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1368662400000",
    "number": "1083738264",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1014 W. BELMONT AVENUE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60657",
            "telephone_number": "773-472-5235",
            "fax_number": "773-472-6321"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1014 W. BELMONT AVENUE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60657",
            "telephone_number": "773-472-5235",
            "fax_number": "773-472-6321"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPECTOR",
        "first_name": "COLEMAN",
        "middle_name": "JAY",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-16",
        "last_updated": "2013-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "IL",
            "license": "021.001732019.023916",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Specialty Care RX, LLC
• Specialty Dental Services LTD
• Specialty Healthcare Services, LTD.
• Specialty Integrative Nutrition, LLC
• Jodine A Speckman, DC
• Howard E. Spector, D.D.S.
• Sally Spector, MS CCC SLP
• Yael Spector
• Spectra Sound Inc.
• Spectra Sound Inc.

• Oral and Maxillofacial Surgery (Dentist) in Chicago, IL
• Providers in Chicago, IL by specialty
• Oral and Maxillofacial Surgery (Dentist) in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2013; 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.