Active NPI
Michael L Spector, DMD
- Periodontics
- Iowa City, IA
National Provider Identifier
1124122130
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Periodontics
- License
- 40232
- Practice address
- 801 Newton Rd
Iowa City, IA 52242-1001 - Phone
- (319) 335-7440
- Fax
- (319) 335-7451
- NPI assigned
- Sep 11, 2006
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Periodontics | 1223P0300X | 40232 | IA | Primary |
Addresses
Primary practice location
801 Newton Rd
Iowa City, IA 52242-1001
Mailing address
322 Dental Science BLDG S
Iowa City, IA 52242-1001
Phone (319) 335-7440
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0476382 | Medicaid | IA |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 40232 | IA | MD | Periodontist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1157932800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1718236800000",
"number": "1124122130",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "322 DENTAL SCIENCE BLDG S",
"city": "IOWA CITY",
"state": "IA",
"postal_code": "522421001",
"telephone_number": "319-335-7440",
"fax_number": "319-335-7451"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "801 NEWTON RD",
"city": "IOWA CITY",
"state": "IA",
"postal_code": "522421001",
"telephone_number": "319-335-7440",
"fax_number": "319-335-7451"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SPECTOR",
"first_name": "MICHAEL",
"middle_name": "L",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-09-11",
"last_updated": "2024-06-13",
"certification_date": "2024-06-06",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0300X",
"taxonomy_group": "",
"desc": "Dentist, Periodontics",
"state": "IA",
"license": "40232",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0476382",
"state": "IA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Iowa City, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.