Individual provider Active NPI

Madison Amspacker

  • Dentist
  • Eglin Afb, FL
National Provider Identifier
1104760941
Registry record updated Aug 1, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
14295570-9926 Issued in UT
Practice address
340 Boatner Rd
Eglin Afb, FL 32542-1391
Phone
(850) 883-8324
NPI assigned
Apr 14, 2026
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 1, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 14295570-9926 UT Primary

Addresses

Primary practice location

340 Boatner Rd
Eglin Afb, FL 32542-1391

Mailing address

340 Boatner Rd BLDG 2751
Eglin Afb, FL 32542-1391
Phone (850) 883-8324

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

NPI Registry JSON

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

{
    "created_epoch": "1776124800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785542400000",
    "number": "1104760941",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "340 BOATNER RD BLDG 2751",
            "city": "EGLIN AFB",
            "state": "FL",
            "postal_code": "325421391",
            "telephone_number": "850-883-8324"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "340 BOATNER RD",
            "city": "EGLIN AFB",
            "state": "FL",
            "postal_code": "325421391",
            "telephone_number": "850-883-8324"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AMSPACKER",
        "first_name": "MADISON",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-04-14",
        "last_updated": "2026-08-01",
        "certification_date": "2026-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "UT",
            "license": "14295570-9926",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eglin Afb, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2026; 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.