Carolynn E.H. Spandau, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

8267 Issued in IN

Practice address

1030 Country Club Rd
Indianapolis, IN 46234-1813

Phone

(317) 271-1488

Fax

(317) 271-2783

NPI assigned

Oct 5, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Female

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

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Caroynn E.H. Spandau D.D.S.

  • Dentist
  • Indianapolis, IN
  • NPI 1699962472
  Authorized official Same address or phone

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

{
    "created_epoch": "1160006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1255427118",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2571 BANTA RD",
            "city": "MARTINSVILLE",
            "state": "IN",
            "postal_code": "461516000",
            "telephone_number": "317-422-5136",
            "fax_number": "317-271-2783"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1030 COUNTRY CLUB RD",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462341813",
            "telephone_number": "317-271-1488",
            "fax_number": "317-271-2783"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPANDAU",
        "first_name": "CAROLYNN",
        "middle_name": "E.H.",
        "name_prefix": "Mrs.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IN",
            "license": "8267",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tabitha Spacht
• Thomas Spaethe
• Roger G. Spahr, M.D.
• Kizzy Spain
• Caitlin R Spall, RRA
• Alexander Lawrence Spanenberg, PHARMD, RPH
• Karen Spangler-Berfield, LCSW
• Julian Jason Spangler
• Kristin Rae Spangler, MS
• Tanea Renee Spanton, PTA

• General Practice Dentistry in Indianapolis, IN
• Providers in Indianapolis, IN by specialty
• General Practice Dentistry in Indiana

• 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.