NPIMap

Spencer Bjarnason, DMD

Individual provider Active NPI Endodontics · Georgetown, TX

NPI 1669760823 · NPPES record last updated Jul 15, 2019

Key facts

NPI
1669760823
Entity type
Individual (NPI type 1)
Primary specialty
Endodontics 1223E0200X
License
27220 (TX)
Practice address
3622 Williams Dr Ste 3
Georgetown, TX 78628-2508
Phone
(512) 948-7624
Fax
(512) 948-7627
NPI assigned
Jul 20, 2011
Sex
Male
Sole proprietor
No

Organizations & group practices 3

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.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
27220TXMDDentist
10509NCMDEndodontist

Practice roles

OrganizationSpecialtyStatusNew patients
Bjarnason Endodontics PLLC Endodontics Current
since Apr 9, 2023		 Accepting new patients
Bjarnason Endodontics PLLC Current Accepting new patients
Benson J. Ybanez DDS and Associates PA Dentist Past Accepting new patients

Locations

3622 Williams Dr
Ste 3
Georgetown, TX 78628
Phone (512) 508-3010

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 27220 TX
Endodontics 1223E0200X 10509 NC
Endodontics 1223E0200X 27220 TX Yes

Addresses

Primary practice location

3622 Williams Dr Ste 3
Georgetown, TX 78628-2508

Mailing address

3622 Williams Dr Ste 3
Georgetown, TX 78628-2508
Phone (512) 948-7624

Other practice location 1

50 Office Park Dr
Jacksonville, NC 28546-3217
Phone (910) 347-5151

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jul 15, 2019.

{
    "created_epoch": "1311120000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1563148800000",
    "number": "1669760823",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3622 WILLIAMS DR STE 3",
            "city": "GEORGETOWN",
            "state": "TX",
            "postal_code": "786282508",
            "telephone_number": "512-948-7624",
            "fax_number": "512-948-7627"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3622 WILLIAMS DR STE 3",
            "city": "GEORGETOWN",
            "state": "TX",
            "postal_code": "786282508",
            "telephone_number": "512-948-7624",
            "fax_number": "512-948-7627"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "50 Office Park Dr",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "NC",
            "postal_code": "285463217",
            "country_code": "US",
            "telephone_number": "910-347-5151",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BJARNASON",
        "first_name": "SPENCER",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-07-20",
        "last_updated": "2019-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TX",
            "license": "27220",
            "primary": false
        },
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "NC",
            "license": "10509",
            "primary": false
        },
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "TX",
            "license": "27220",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Georgetown, TX

All providers in Georgetown, TX · Endodontics in Texas

Sources for this page

Verify at the official NPI Registry.