Glynn Stephen Spencer Jr., D.D.S.

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

2000161231 Issued in MO

Practice address

301 NE Mulberry St
Suite #201
Lees Summit, MO 64086-5818

Phone

(816) 607-6000

Fax

(816) 607-6001

NPI assigned

Nov 27, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Spencer and Spencer Pediatric Dentistry, DDS, PC

  • Pediatric Dentistry
  • Lees Summit, MO
  • NPI 1679880124
  NPD (past) Authorized official

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

{
    "created_epoch": "1133049600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1284681600000",
    "number": "1306829080",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 NE MULBERRY ST",
            "address_2": "SUITE #201",
            "city": "LEES SUMMIT",
            "state": "MO",
            "postal_code": "640865818",
            "telephone_number": "816-607-6000",
            "fax_number": "816-607-6001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 NE MULBERRY ST",
            "address_2": "SUITE #201",
            "city": "LEES SUMMIT",
            "state": "MO",
            "postal_code": "640865818",
            "telephone_number": "816-607-6000",
            "fax_number": "816-607-6001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPENCER",
        "first_name": "GLYNN",
        "middle_name": "STEPHEN",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-27",
        "last_updated": "2010-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "MO",
            "license": "2000161231",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sam Michael Spangler, RN, BSN, CCRN
• Rosann Elizabeth Sparks, LMFT
• Speech and Language Solutions, LLC
• Amy Beth Speer, OTR, MOT, CHT
• Spencer and Spencer Pediatric Dentistry, DDS, PC
• Jodie L Spencer, DDS
• Spira Care, LLC
• Philip John Spitznagle, RPH
• Bernadette P Spooner Thompson, ED.S.
• Sports Med Plus of Lees Summit, LLC

• Pediatric Dentistry in Lees Summit, MO
• Providers in Lees Summit, MO by specialty
• Pediatric Dentistry in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2010; 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.