Individual provider Active NPI

Michael Clark Spielberger, DMD

  • General Practice Dentistry
  • Glens Falls, NY
National Provider Identifier
1215131669
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
34717 Issued in NY
Practice address
21 Pine St
Glens Falls, NY 12801-3410
Phone
(518) 792-3256
Fax
(518) 792-3789
NPI assigned
Jun 11, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 34717 NY Primary

Addresses

Primary practice location

21 Pine St
Glens Falls, NY 12801-3410

Mailing address

11 Sheraton LN S
Queensbury, NY 12804-7727
Phone (518) 793-6595

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

State licenses

LicenseStateTypeSpecialty
34717NYMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1181520000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1215131669",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 SHERATON LN S",
            "city": "QUEENSBURY",
            "state": "NY",
            "postal_code": "128047727",
            "telephone_number": "518-793-6595"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 PINE ST",
            "city": "GLENS FALLS",
            "state": "NY",
            "postal_code": "128013410",
            "telephone_number": "518-792-3256",
            "fax_number": "518-792-3789"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPIELBERGER",
        "first_name": "MICHAEL",
        "middle_name": "CLARK",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-06-11",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "34717",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glens Falls, NY

Sources for this page

  • 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.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.