Individual provider Active NPI

Laine Anne Spadola, D.D.S.

  • General Practice Dentistry
  • Monticello, NY
National Provider Identifier
1295090348
Registry record updated Jul 30, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
56702-1 Issued in NY
Practice address
606 Old Route 17
Discovery Health Center
Monticello, NY 12701
Phone
(845) 707-8400
Fax
(845) 707-8916
NPI assigned
Jul 5, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 30, 2018

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 56702-1 NY Primary

Addresses

Primary practice location

606 Old Route 17
Discovery Health Center
Monticello, NY 12701

Mailing address

PO Box 840
Harris, NY 12742
Phone (845) 707-8400

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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

Enrollment IDStateProvider typePAC IDDetails
I20180316000997 NY Practitioner - Dentist 7911269626 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
56702-1NYMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
The Center for Discovery Inc CurrentSince Dec 3, 2017 Accepting new patients
The Center for Discovery Inc CurrentSince Dec 3, 2017 Accepting new patients

Locations

606 Old Route 17
Monticello, NY 12701
Phone (845) 707-8400

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1341446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1532908800000",
    "number": "1295090348",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 840",
            "city": "HARRIS",
            "state": "NY",
            "postal_code": "12742",
            "telephone_number": "845-707-8400",
            "fax_number": "845-707-8916"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "606 OLD ROUTE 17",
            "address_2": "DISCOVERY HEALTH CENTER",
            "city": "MONTICELLO",
            "state": "NY",
            "postal_code": "12701",
            "telephone_number": "845-707-8400",
            "fax_number": "845-707-8916"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPADOLA",
        "first_name": "LAINE",
        "middle_name": "ANNE",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-07-05",
        "last_updated": "2018-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "56702-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Monticello, NY

Sources for this page

Verify at the official NPI Registry.