Active NPI
Spencer Svetcov, DDS
- Dentist
- Flushing, NY
National Provider Identifier
1417315953
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 50 058680
- Practice address
- 20906 Union Tpke
Flushing, NY 11364-3238 - Phone
- (718) 479-9400
- NPI assigned
- Jan 28, 2016
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Dentist | 122300000X | 50 058680 | NY | Primary |
Addresses
Primary practice location
20906 Union Tpke
Flushing, NY 11364-3238
Mailing address
41 Wyndham Close
White Plains, NY 10605-2100
Phone (914) 437-7013
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 50 058680 | NY | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1453939200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1484697600000",
"number": "1417315953",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "41 WYNDHAM CLOSE",
"city": "WHITE PLAINS",
"state": "NY",
"postal_code": "106052100",
"telephone_number": "914-437-7013"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "20906 UNION TPKE",
"city": "FLUSHING",
"state": "NY",
"postal_code": "113643238",
"telephone_number": "718-479-9400"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SVETCOV",
"first_name": "SPENCER",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2016-01-28",
"last_updated": "2017-01-18",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "NY",
"license": "50 058680",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Flushing, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.