Raymond Wendel Spore Sr., DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

18020 Issued in CA

Practice address

635 Anderson Rd
Ste #14
Davis, CA 95616

Phone

(530) 756-0953

Fax

(530) 756-0953

NPI assigned

Aug 30, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Raymond W Spore Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1518076793",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "635 ANDERSON RD",
            "address_2": "STE #14",
            "city": "DAVIS",
            "state": "CA",
            "postal_code": "95616",
            "telephone_number": "530-756-0953",
            "fax_number": "530-756-3588"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "635 ANDERSON RD",
            "address_2": "STE #14",
            "city": "DAVIS",
            "state": "CA",
            "postal_code": "95616",
            "telephone_number": "530-756-0953",
            "fax_number": "530-756-0953"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPORE",
        "first_name": "RAYMOND",
        "middle_name": "WENDEL",
        "name_prefix": "Mr.",
        "name_suffix": "Sr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-30",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "18020",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "RAYMOND",
            "last_name": "SPORE",
            "middle_name": "W",
            "credential": "DDS A DENTAL CORPORA",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Marion P Spera, MSW
• Nicholas Anthony Spilka
• Spine & Nerve Diagnostic Center
• Teri Spiritosanto, MFT
• Kimberly Lynn Spitz
• Raymond Wendell Spore Jr., D.C.
• Jonathan Sprague
• Ronnie Vernon Sprinkle, M.D.
• Manjinder Singh Sran, MD
• Vishnudharshini K Sridharan

• General Practice Dentistry in Davis, CA
• Providers in Davis, CA by specialty
• General Practice Dentistry in California

• 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.