Daniel Emerson Spencer, DMD

Primary specialty

Public Health DentistryTaxonomy code 1223D0001X

License

019-032602 Issued in IL

Practice address

330 Vermont St Ste 100
Quincy, IL 62301-2700

Phone

(217) 222-8440

NPI assigned

Jun 1, 2020

Last updated

Jul 22, 2020By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Board of Trustees of Southern Illinois University

  • Federally Qualified Health Center (FQHC)
  • Quincy, IL
  • NPI 1083121537
  NPD

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

{
    "created_epoch": "1590969600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1595376000000",
    "number": "1306460845",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 COTTONWOOD RD",
            "city": "FRANKFORT",
            "state": "IL",
            "postal_code": "604231009",
            "telephone_number": "815-953-1655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "330 VERMONT ST STE 100",
            "city": "QUINCY",
            "state": "IL",
            "postal_code": "623012700",
            "telephone_number": "217-222-8440"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "501 Cottonwood Rd",
            "address_purpose": "LOCATION",
            "city": "Frankfort",
            "state": "IL",
            "postal_code": "604231009",
            "country_code": "US",
            "telephone_number": "815-953-1655",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "330 Vermont St Ste 100",
            "address_purpose": "LOCATION",
            "city": "Quincy",
            "state": "IL",
            "postal_code": "623012700",
            "country_code": "US",
            "telephone_number": "217-222-8440",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SPENCER",
        "first_name": "DANIEL",
        "middle_name": "EMERSON",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-06-01",
        "last_updated": "2020-07-22",
        "certification_date": "2020-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019-032602",
            "primary": false
        },
        {
            "code": "1223D0001X",
            "taxonomy_group": "",
            "desc": "Dentist, Dental Public Health",
            "state": "IL",
            "license": "019-032602",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elizabeth Sowers
• Cynthia S. Spake
• Shawn William Sparrow, BS
• Steven Spears, LCPC
• Spec Ed Assoc of Adams County
• Brian S Spooner, O.D.
• Henry Albert Spradlin, CRNA
• Mark G Sprague, DC
• Brooke Ann Spring, D.P.T
• Sprout Therapy Services (Sprout Therapy Co.)

• Public Health Dentistry in Quincy, IL
• Providers in Quincy, IL by specialty
• Public Health Dentistry in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2020; 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.