Active NPI
Peter M Spradling, DMD
- Endodontics
- Victoria, TX
National Provider Identifier
1386789394
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Endodontics
- License
- 17455
- Practice address
- 103 Professional Park Dr
Victoria, TX 77904-2351 - Phone
- (361) 576-1235
- NPI assigned
- Feb 20, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Endodontics | 1223E0200X | 17455 | TX | Primary |
Addresses
Primary practice location
103 Professional Park Dr
Victoria, TX 77904-2351
Mailing address
306 Ashland CRK
Victoria, TX 77901-3685
Phone (361) 582-4968
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 17455 | TX | MD | Addiction (Substance Use Disorder) Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1171929600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1386789394",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "306 ASHLAND CRK",
"city": "VICTORIA",
"state": "TX",
"postal_code": "779013685",
"telephone_number": "361-582-4968"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "103 PROFESSIONAL PARK DR",
"city": "VICTORIA",
"state": "TX",
"postal_code": "779042351",
"telephone_number": "361-576-1235"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SPRADLING",
"first_name": "PETER",
"middle_name": "M",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-02-20",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223E0200X",
"taxonomy_group": "",
"desc": "Dentist, Endodontics",
"state": "TX",
"license": "17455",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Victoria, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.