Individual provider Active NPI

Charles M Spitz, DDS

  • Dentist
  • San Mateo, CA
National Provider Identifier
1386792919
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
22672 Issued in CA
Practice address
50 S San Mateo Dr
San Mateo, CA 94401-3857
Phone
(650) 375-8300
Fax
(650) 375-8130
NPI assigned
Jan 8, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 22672 CA Primary

Addresses

Primary practice location

50 S San Mateo Dr
San Mateo, CA 94401-3857

Mailing address

50 S San Mateo Dr
San Mateo, CA 94401-3857
Phone (650) 375-8300

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)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1168214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1386792919",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50 S SAN MATEO DR",
            "city": "SAN MATEO",
            "state": "CA",
            "postal_code": "944013857",
            "telephone_number": "650-375-8300",
            "fax_number": "650-375-8130"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 S SAN MATEO DR",
            "city": "SAN MATEO",
            "state": "CA",
            "postal_code": "944013857",
            "telephone_number": "650-375-8300",
            "fax_number": "650-375-8130"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPITZ",
        "first_name": "CHARLES",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-08",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "22672",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Mateo, CA

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.

Verify at the official NPI Registry.