Individual provider Active NPI

Elizabeth Drew Spence, D.M.D.

  • General Practice Dentistry
  • Naperville, IL
National Provider Identifier
1083800346
Registry record updated Sep 20, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Practice address
535 Fairway Dr
135
Naperville, IL 60563-3938
Phone
(630) 548-4140
NPI assigned
Sep 20, 2007
Last updated
Sep 20, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 20, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X IL Primary

Addresses

Primary practice location

535 Fairway Dr
135
Naperville, IL 60563-3938

Mailing address

2720 S Highland Ave
Apt 547
Lombard, IL 60148-5302
Phone (215) 605-5705

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161227000628 IL Order and Referring Only - DentistPractitioner - Dentist 6507147931

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
019.027445ILMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1190246400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1190246400000",
    "number": "1083800346",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2720 S HIGHLAND AVE",
            "address_2": "APT 547",
            "city": "LOMBARD",
            "state": "IL",
            "postal_code": "601485302",
            "telephone_number": "215-605-5705"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "535 FAIRWAY DR",
            "address_2": "135",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605633938",
            "telephone_number": "630-548-4140"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPENCE",
        "first_name": "ELIZABETH",
        "middle_name": "DREW",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-09-20",
        "last_updated": "2007-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Naperville, IL

Sources for this page

Verify at the official NPI Registry.