Spencer Alexander Marrero, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D6089 Issued in OR

Practice address

16400 SW Hart Rd
Suite a
Beaverton, OR 97007-3457

Phone

(503) 649-7701

NPI assigned

Jun 6, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Aleksandr Yanchuk DMD LLC

  dba Summercrest Dental

  • Dental Clinic/Center
  • Beaverton, OR
  • NPI 1811880271
  NPD (past)
• S. Alexander Marrero DDS, PC

  dba Summercrest Dental

  • Dental Clinic/Center
  • Beaverton, OR
  • NPI 1619235983
  NPD (past)

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

{
    "created_epoch": "1181088000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1194928390",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16400 SW HART RD",
            "address_2": "SUITE A",
            "city": "BEAVERTON",
            "state": "OR",
            "postal_code": "970073457",
            "telephone_number": "503-649-7701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16400 SW HART RD",
            "address_2": "SUITE A",
            "city": "BEAVERTON",
            "state": "OR",
            "postal_code": "970073457",
            "telephone_number": "503-649-7701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARRERO",
        "first_name": "SPENCER",
        "middle_name": "ALEXANDER",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-06-06",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OR",
            "license": "D6089",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elisabeth Ruth Marker, PHARM.D.
• Colton James Markham, BA
• Addison Marler, MA
• Elis Marquez Ruiz
• Christian B Marrero
• Tamara Marriott
• Brooke Nicole Marshall
• Chandler Marshall
• Kathryn Elizabeth Marshall, PSY.D.
• Linda L Marshall, MSW LCSW

• General Practice Dentistry in Beaverton, OR
• Providers in Beaverton, OR by specialty
• General Practice Dentistry in Oregon

• 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.