Active NPI
John Keith Spitznagel Jr., D.D.S., PH.D.
- Periodontics
- Parkton, MD
National Provider Identifier
1255500807
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Periodontics
- License
- 13864
- Practice address
- 17818 Foreston Rd
Parkton, MD 21120-9657 - Phone
- (443) 465-4745
- NPI assigned
- Feb 28, 2008
- Last updated
- Feb 28, 2008
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Periodontics | 1223P0300X | 13864 | MD | Primary |
| Periodontics | 1223P0300X | DS037003 | PA | |
| Periodontics | 1223P0300X | 15287 | MA |
Addresses
Primary practice location
17818 Foreston Rd
Parkton, MD 21120-9657
Mailing address
17818 Foreston Rd
Parkton, MD 21120-9657
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
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 13864 | MD | MD | Periodontist |
| DS037003 | PA | MD | Periodontist |
| 15287 | MA | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1204156800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1204156800000",
"number": "1255500807",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "17818 FORESTON RD",
"city": "PARKTON",
"state": "MD",
"postal_code": "211209657"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "17818 FORESTON RD",
"city": "PARKTON",
"state": "MD",
"postal_code": "211209657",
"telephone_number": "443-465-4745"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SPITZNAGEL",
"first_name": "JOHN",
"middle_name": "KEITH",
"name_prefix": "Dr.",
"name_suffix": "Jr.",
"credential": "D.D.S., PH.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2008-02-28",
"last_updated": "2008-02-28",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0300X",
"taxonomy_group": "",
"desc": "Dentist, Periodontics",
"state": "MD",
"license": "13864",
"primary": true
},
{
"code": "1223P0300X",
"taxonomy_group": "",
"desc": "Dentist, Periodontics",
"state": "PA",
"license": "DS037003",
"primary": false
},
{
"code": "1223P0300X",
"taxonomy_group": "",
"desc": "Dentist, Periodontics",
"state": "MA",
"license": "15287",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Parkton, MD
- Jennifer Seman, PA-C
- Sensational Sustenance, LLC
- Chalyse H. Shaw, DC
- Erica Silverstein, PHARMD
- Maura Alexandra Simms, DPT ATC
- Renee Marie Svehla Knutson
- Thomas S Melanson DDS LLC
- University of Maryland St. Joseph Medical Group, LLC (University of Maryland St. Joseph Medical Group)
- Cynthia Vice, LMT
- Angelo Christopher Voxakis, RPH.
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.