Active NPI
Paul Glenn Spradlin, DMD
- Dentist
- Riverview, FL
National Provider Identifier
1467053876
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 10534
- Practice address
- 10389 Big Bend Rd
Riverview, FL 33578-7414 - Phone
- (813) 304-2600
- NPI assigned
- Nov 3, 2020
- 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 |
|---|---|---|---|---|
| Dentist | 122300000X | 10534 | KY | Primary |
Addresses
Primary practice location
10389 Big Bend Rd
Riverview, FL 33578-7414
Mailing address
324 E Main St Unit 228
Louisville, KY 40202-1289
Phone (606) 923-0755
Other names 1
- N/a N/a N/a
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 |
|---|---|---|---|
| 10534 | KY | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| University Physicians & Surgeons, Inc. | Past | Accepting new patients | |
| University Physicians & Surgeons, Inc | Dentist | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Internal Medicine Physician
- Huntington, WV
- NPI 1730183286
Dentist
-
- Health & Wellness Coach
- Louisa, KY
- NPI 1073256665
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1604361600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1667520000000",
"number": "1467053876",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "324 E MAIN ST UNIT 228",
"city": "LOUISVILLE",
"state": "KY",
"postal_code": "402021289",
"telephone_number": "606-923-0755"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10389 BIG BEND RD",
"city": "RIVERVIEW",
"state": "FL",
"postal_code": "335787414",
"telephone_number": "813-304-2600"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SPRADLIN",
"first_name": "PAUL",
"middle_name": "GLENN",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-11-03",
"last_updated": "2022-11-04",
"certification_date": "2022-11-04",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "KY",
"license": "10534",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "N/A",
"last_name": "N/A",
"middle_name": "N/A",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Riverview, FL
- Spine and Nerve Center Riverview, LLC
- Sports and Orthopedic Rehabilitation Services Inc
- Sports and Orthopedic Rehabilitation Services Inc
- Steven Blake Spoto, DMD
- Frances Spradley
- Springwell Health Inc.
- St Joseph'S Diagnostic Center LLC
- St. Joseph'S Hospital, Inc.
- Alison Staeheli
- Allison Diane Hebert Stainton, LCSW
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.