Active NPI
David F Spooner, DDS
- Dentist
- Bainbridge Island, WA
National Provider Identifier
1093939340
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 5492
- Practice address
- 121 Madison Ave N
Bainbridge Island, WA 98110-1813 - Phone
- (206) 518-2419
- NPI assigned
- Apr 11, 2007
- 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 |
|---|---|---|---|---|
| Dentist | 122300000X | 5492 | WA | Primary |
Addresses
Primary practice location
121 Madison Ave N
Bainbridge Island, WA 98110-1813
Mailing address
121 Madison Ave N
Bainbridge Island, WA 98110-1813
Phone (206) 518-2419
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 911129342 | Other | FEDERAL TAX ID |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 5492 | WA | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1176249600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1468713600000",
"number": "1093939340",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "121 MADISON AVE N",
"city": "BAINBRIDGE ISLAND",
"state": "WA",
"postal_code": "981101813",
"telephone_number": "206-518-2419"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "121 MADISON AVE N",
"city": "BAINBRIDGE ISLAND",
"state": "WA",
"postal_code": "981101813",
"telephone_number": "206-518-2419"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SPOONER",
"first_name": "DAVID",
"middle_name": "F",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-04-11",
"last_updated": "2016-07-17",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "WA",
"license": "5492",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "FEDERAL TAX ID",
"identifier": "911129342",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Bainbridge Island, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.