Thomas E Spray, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

11485 Issued in MN

Practice address

112 7TH Ave S
South St Paul, MN 55075-2202

Phone

(651) 451-8303

NPI assigned

Dec 28, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Open Cities Health Center, Inc.

  • Federally Qualified Health Center (FQHC)
  • St. Paul, MN
  • NPI 1225101405

  MN

  Medicare reassignment

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

{
    "created_epoch": "1167264000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1508922212",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "112 7TH AVE S",
            "city": "SOUTH ST PAUL",
            "state": "MN",
            "postal_code": "550752202",
            "telephone_number": "651-451-8303"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "112 7TH AVE S",
            "city": "SOUTH ST PAUL",
            "state": "MN",
            "postal_code": "550752202",
            "telephone_number": "651-451-8303"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPRAY",
        "first_name": "THOMAS",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-28",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MN",
            "license": "11485",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ehpaw Wah So
• Pah Soe
• South St. Paul Family Chiropractic, LTD
• South St. Paul Fire Department
• Special School Dist 6 Dakota Co
• St Paul Primary Care
• St. Paul Oral Surgery, P.a.
• Billie Jo Story, LPCC
• Amalo Imana Tarafa
• TDF Transportation LLC

• All providers in South St Paul, MN
• General Practice Dentistry in Minnesota

• 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.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.