Active NPI
Joshua J Spiegl, DDS
- Pediatric Dentistry
- Wausau, WI
National Provider Identifier
1477520815
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Dentistry
- License
- 6092-15
- Practice address
- 413 N 17TH Ave
Wausau, WI 54401-4226 - Phone
- (715) 842-4649
- Fax
- (715) 842-7331
- NPI assigned
- Mar 3, 2006
- 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 | D11728 | MN | |
| Pediatric Dentistry | 1223P0221X | 6092-15 | WI | Primary |
Addresses
Primary practice location
413 N 17TH Ave
Wausau, WI 54401-4226
Mailing address
413 N 17TH Ave
Wausau, WI 54401-4226
Phone (715) 842-4649
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 338810600 | Medicaid | WI |
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 |
|---|---|---|---|
| D11728 | MN | MD | Pediatric Dentist |
| 6092-15 | WI | MD | Pediatric Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1141344000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1302566400000",
"number": "1477520815",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "413 N 17TH AVE",
"city": "WAUSAU",
"state": "WI",
"postal_code": "544014226",
"telephone_number": "715-842-4649",
"fax_number": "715-842-7331"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "413 N 17TH AVE",
"city": "WAUSAU",
"state": "WI",
"postal_code": "544014226",
"telephone_number": "715-842-4649",
"fax_number": "715-842-7331"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SPIEGL",
"first_name": "JOSHUA",
"middle_name": "J",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-03-03",
"last_updated": "2011-04-12",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0221X",
"taxonomy_group": "",
"desc": "Dentist, Pediatric Dentistry",
"state": "MN",
"license": "D11728",
"primary": false
},
{
"code": "1223P0221X",
"taxonomy_group": "",
"desc": "Dentist, Pediatric Dentistry",
"state": "WI",
"license": "6092-15",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "338810600",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Wausau, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.