Active NPI
Richard Glen Spell, D.D.S.
- General Practice Dentistry
- Covington, LA
National Provider Identifier
1598881625
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 4117
- Practice address
- 79132 Hwy 40
Covington, LA 70435 - Phone
- (985) 893-3900
- Fax
- (985) 893-2910
- NPI assigned
- Mar 21, 2007
- Last updated
- Jul 8, 2007
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 4117 | TN | Primary |
Addresses
Primary practice location
79132 Hwy 40
Covington, LA 70435
Mailing address
17517 Million Dollar Rd.
Covington, LA 70435
Phone (985) 892-7665
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 |
|---|---|---|---|
| 4117 | TN | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1174435200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1598881625",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "17517 MILLION DOLLAR RD.",
"city": "COVINGTON",
"state": "LA",
"postal_code": "70435",
"telephone_number": "985-892-7665"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "79132 HWY 40",
"city": "COVINGTON",
"state": "LA",
"postal_code": "70435",
"telephone_number": "985-893-3900",
"fax_number": "985-893-2910"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SPELL",
"first_name": "RICHARD",
"middle_name": "GLEN",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-03-21",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "TN",
"license": "4117",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Covington, LA
Sources for this page
- 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.