David Arnold Spencer, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

1165 Issued in AK

Practice address

806 S Nordic
Petersburg, AK 99833-0469

Phone

(907) 772-9246

Fax

(907) 772-9278

NPI assigned

Apr 17, 2007

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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OR

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

Medicare enrollment (NPD)

Enrolled

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.

• Petersburg Dental, Inc.

  • Dentist
  • Petersburg, AK
  • NPI 1932543345
  NPD (past)

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

{
    "created_epoch": "1176768000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1114143203",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 469",
            "city": "PETERSBURG",
            "state": "AK",
            "postal_code": "998330469",
            "telephone_number": "907-772-9246",
            "fax_number": "907-772-9278"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "806 S NORDIC",
            "city": "PETERSBURG",
            "state": "AK",
            "postal_code": "998330469",
            "telephone_number": "907-772-9246",
            "fax_number": "907-772-9278"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPENCER",
        "first_name": "DAVID",
        "middle_name": "ARNOLD",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-17",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AK",
            "license": "1165",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "DD7464",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Laraine K Smith, RNC
• South East Alaska Regional Health Consortium
• Southeast Alaska Regional Health Consortium
• Southeast Alaska Regional Health Consortium
• Southeast Alaska Regional Health Consortium
• Savannah Sperl
• Richard E Sprague, DMD
• Jay Stanton Gregor
• Lea M Stanton Gregor, LCPC
• Kirsten Irene Susort

• General Practice Dentistry in Petersburg, AK
• Providers in Petersburg, AK by specialty
• General Practice Dentistry in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.