Caitlin Spacek, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

2404 Issued in ND

Practice address

2704 12TH St S
Moorhead, MN 56560-4621

Phone

(218) 233-0570

NPI assigned

Jun 17, 2020

Sex

Female

Sole proprietor

No

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.

• Krista Johnson DMD PLLC

  • General Practice Dentistry
  • Fargo, ND
  • NPI 1598203606

  General Practice

  NPD (past)

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on May 13, 2024.

{
    "created_epoch": "1592352000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715558400000",
    "number": "1336765254",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1650 45TH ST S STE 108",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581033247",
            "telephone_number": "701-526-4652"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2704 12TH ST S",
            "city": "MOORHEAD",
            "state": "MN",
            "postal_code": "565604621",
            "telephone_number": "218-233-0570"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3300 32nd Ave S",
            "address_purpose": "LOCATION",
            "city": "Grand Forks",
            "state": "ND",
            "postal_code": "582015801",
            "country_code": "US",
            "telephone_number": "701-765-3494",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SPACEK",
        "first_name": "CAITLIN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-06-17",
        "last_updated": "2024-05-13",
        "certification_date": "2024-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MN",
            "license": "D14526",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "ND",
            "license": "2404",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brianna Solum
• Solutions Behavioral Healthcare Professionals, PC
• Taylor Somers
• Jane Soto
• Sound Mind Counseling, PLLC
• Steve Spader, L.AC.
• Latisha Mary Spanier
• Heather A Speer, LICSW
• Benjamin Luke Spurgeon, MS, LAT, ATC
• Michelle Stachowski, LSN,RN,PHN

• All providers in Moorhead, MN
• General Practice Dentistry in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2024; 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.