NPIMap

Organization Active NPI

Spenceburzynski LLC

Doing business as Innovative Orthodontics

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Cape Girardeau, MO
National Provider Identifier
1114631439
Registry record updated Jan 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
Legal business name
SPENCEBURZYNSKI LLC
Doing business as
Innovative Orthodontics
Practice address
2103 Broadway
Cape Girardeau, MO 63701
Phone
(573) 332-7223
Fax
(573) 334-7379
NPI assigned
Jan 11, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 11, 2023

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

Authorized official

Name
Dr. Terry M Spence, D.D.S., M.D.S.NPI 1215259429
Title
Owner/Provider
Phone
(573) 450-1141

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223X0400X Primary

Addresses

Primary practice location

2103 Broadway
Cape Girardeau, MO 63701

Mailing address

2103 Broadway
Cape Girardeau, MO 63701
Phone (573) 332-7223

Other names 1

  • Innovative Orthodontics Doing business as

National Provider Directory

National Provider Directory

Locations

2103 Broadway St
Cape Girardeau, MO 63701
Phone (573) 332-7223

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1673395200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1673395200000",
    "number": "1114631439",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2103 BROADWAY",
            "city": "CAPE GIRARDEAU",
            "state": "MO",
            "postal_code": "63701",
            "telephone_number": "573-332-7223",
            "fax_number": "573-334-7379"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2103 BROADWAY",
            "city": "CAPE GIRARDEAU",
            "state": "MO",
            "postal_code": "63701",
            "telephone_number": "573-332-7223",
            "fax_number": "573-334-7379"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPENCEBURZYNSKI LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-01-11",
        "last_updated": "2023-01-11",
        "certification_date": "2023-01-11",
        "status": "A",
        "authorized_official_last_name": "SPENCE",
        "authorized_official_first_name": "TERRY",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER/PROVIDER",
        "authorized_official_telephone_number": "573-450-1141",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S., M.D.S."
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Innovative Orthodontics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Cape Girardeau, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2023; 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.