Active NPI
David Garrett Spruill, D.D.S.
- Pediatric Dentistry
- Chesapeake, VA
National Provider Identifier
1437316015
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Dentistry
- License
- 0401412764
- Practice address
- 1059 Eden Way North, Suite 100
Chesapeake, VA 23320 - Phone
- (757) 547-2266
- NPI assigned
- May 21, 2008
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Dentistry | 1223P0221X | 8583 | NC | |
| Pediatric Dentistry | 1223P0221X | 0401412764 | VA | Primary |
Addresses
Primary practice location
1059 Eden Way North, Suite 100
Chesapeake, VA 23320
Mailing address
1059 Eden Way North, Suite 100
Chesapeake, VA 23320
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
- Opted out of Medicare
- Yes, effective Nov 8, 2013 through Nov 8, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 8583 | NC | MD | Pediatric Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Dr Daniel M Etheridge DDS LTD | 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": "1211328000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1275523200000",
"number": "1437316015",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1059 EDEN WAY NORTH, SUITE 100",
"city": "CHESAPEAKE",
"state": "VA",
"postal_code": "23320"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1059 EDEN WAY NORTH, SUITE 100",
"city": "CHESAPEAKE",
"state": "VA",
"postal_code": "23320",
"telephone_number": "757-547-2266"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SPRUILL",
"first_name": "DAVID",
"middle_name": "GARRETT",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-05-21",
"last_updated": "2010-06-03",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0221X",
"taxonomy_group": "",
"desc": "Dentist, Pediatric Dentistry",
"state": "NC",
"license": "8583",
"primary": false
},
{
"code": "1223P0221X",
"taxonomy_group": "",
"desc": "Dentist, Pediatric Dentistry",
"state": "VA",
"license": "0401412764",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Chesapeake, VA
- Sport Medicine and Orthopaedic Center Inc
- Sports Medicine and Orthopaedic Center
- Spring of Life Chiropractic LLC
- Laura Whisnant Sprinkle, LPC
- Brianna Tai Spruill
- Delphia Spruill, CSAC
- Nicole Spruill, ATC
- Harry Wooten Squire, DDS
- St Rapheal Healthcare LLC
- Stacie Davis LLC (Chesapeake Counseling Center)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.