Craig Spodak DMD PA

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

14948 Issued in FL

Legal business name

CRAIG SPODAK DMD PA

Doing business as

Spodak Dental Group

Practice address

3911 West Atlantic Ave
Delray Beach, FL 33445-3902

Phone

(561) 498-0050

Fax

(561) 498-0841

NPI assigned

Oct 29, 2008

Last updated

Jul 17, 2014By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Craig Spodak, DMDNPI 1073522017

Title

President

Phone

(561) 498-0050

Specialties & licenses 1

Addresses

Other names 1

• Spodak Dental Group Doing business as

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Craig Spodak, DMD

  • General Practice Dentistry
  • Delray Beach, FL
  • NPI 1073522017
  Authorized official Same address or phone

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

{
    "created_epoch": "1225238400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1405555200000",
    "number": "1285887679",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3911 WEST ATLANTIC AVE",
            "city": "DELRAY BEACH",
            "state": "FL",
            "postal_code": "334453902",
            "telephone_number": "561-498-0050",
            "fax_number": "561-498-0841"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3911 WEST ATLANTIC AVE",
            "city": "DELRAY BEACH",
            "state": "FL",
            "postal_code": "334453902",
            "telephone_number": "561-498-0050",
            "fax_number": "561-498-0841"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CRAIG SPODAK DMD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-10-29",
        "last_updated": "2014-07-17",
        "status": "A",
        "authorized_official_last_name": "SPODAK",
        "authorized_official_first_name": "CRAIG",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "561-498-0050",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "14948",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Spodak Dental Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• General Practice Dentistry in Delray Beach, FL
• Providers in Delray Beach, FL by specialty
• General Practice Dentistry in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2014; 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.