Marvin L Speer, DDS MS

Primary specialty

EndodonticsTaxonomy code 1223E0200X

License

136000238 Issued in IL

Practice address

2800 College Ave BLDG 273
Alton, IL 62002-4700

Phone

(618) 474-7068

NPI assigned

Oct 14, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in WV

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

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

State licenses

Practice roles

Locations

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.

• Siu Dental Associates

  • General Practice Dentistry
  • Edwardsville, IL
  • NPI 1659957850
  NPD

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

{
    "created_epoch": "1129248000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670976000000",
    "number": "1295724045",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2800 COLLEGE AVE BLDG 273",
            "city": "ALTON",
            "state": "IL",
            "postal_code": "620024700",
            "telephone_number": "618-474-7068"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2800 COLLEGE AVE BLDG 273",
            "city": "ALTON",
            "state": "IL",
            "postal_code": "620024700",
            "telephone_number": "618-474-7068"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPEER",
        "first_name": "MARVIN",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "DDS MS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-14",
        "last_updated": "2022-12-14",
        "certification_date": "2022-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "IL",
            "license": "136.000238",
            "primary": false
        },
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "IL",
            "license": "136000238",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Southern Illinois Healthcare Foundation, Inc
• Southern Illinois Healthcare Foundation, Inc.
• Southern Illinois Healthcare Foundation, Inc.
• Southern Illinois University Edwardsville School of Dental Medicine
• Jennifer Sparks
• Eric M Speh, DC
• Lauren Spiroff
• St Louis Cardiology Consultants LTD
• St Louis Cardiology Consultants, LTD
• Erik Christian Stabell, MD

• Endodontics in Alton, IL
• Providers in Alton, IL by specialty
• Endodontics in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2022; 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.