Individual provider Active NPI

Kent James Spurling, D.M.D.

  • Dentist
  • Mesa, AZ
National Provider Identifier
1366418162
Registry record updated Mar 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
D6969 Issued in AZ
Practice address
2727 E. McKellips Rd
Suite 101
Mesa, AZ 85213
Phone
(480) 612-6352
Fax
(480) 893-0596
NPI assigned
Feb 23, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 25, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X D6969 AZ Primary

Addresses

Primary practice location

2727 E. McKellips Rd
Suite 101
Mesa, AZ 85213

Mailing address

2727 E McKellips Rd
Suite 101
Mesa, AZ 85213
Phone (480) 612-6352

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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
I20170109002345 AZ Order and Referring Only - Other (Physician)Practitioner - Other (Physician) 0244511152

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
D6969AZMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Light Touch Laser and Dental Implant Center, PLLC Past Accepting new patients

Organizations & group practices 1

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": "1140652800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711324800000",
    "number": "1366418162",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2727 E MCKELLIPS RD",
            "address_2": "SUITE 101",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "85213",
            "telephone_number": "480-612-6352",
            "fax_number": "480-893-0596"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2727 E. MCKELLIPS RD",
            "address_2": "SUITE 101",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "85213",
            "telephone_number": "480-612-6352",
            "fax_number": "480-893-0596"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPURLING",
        "first_name": "KENT",
        "middle_name": "JAMES",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-23",
        "last_updated": "2024-03-25",
        "certification_date": "2024-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "AZ",
            "license": "D6969",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mesa, AZ

Sources for this page

Verify at the official NPI Registry.