Mark Patrick Spaude, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D12953 Issued in MN

Practice address

822 Main Street Suite a
Elk River, MN 55330

Phone

(763) 441-2170

Fax

(763) 441-9045

NPI assigned

Jun 10, 2011

Last updated

Mar 17, 2018By 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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Dental Care Associates of Buffalo PA

  • Dental Clinic/Center
  • Buffalo, MN
  • NPI 1477564219
  NPD (past)
• TS Dental Services LLC

  dba Dental Care Associates of Buffalo

  • Dental Clinic/Center
  • Buffalo, MN
  • NPI 1497614192
  NPD (past)

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

{
    "created_epoch": "1307664000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1679868335",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "822 MAIN STREET SUITE A",
            "city": "ELK RIVER",
            "state": "MN",
            "postal_code": "55330",
            "telephone_number": "763-441-2170",
            "fax_number": "763-441-9045"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "822 MAIN STREET SUITE A",
            "city": "ELK RIVER",
            "state": "MN",
            "postal_code": "55330",
            "telephone_number": "763-441-2170",
            "fax_number": "763-441-9045"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "306 BRIGHTON AVENUE SOUTH",
            "address_purpose": "LOCATION",
            "city": "BUFFALO",
            "state": "MN",
            "postal_code": "553132318",
            "country_code": "US",
            "telephone_number": "763-682-2572",
            "fax_number": "763-682-2700",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SPAUDE",
        "first_name": "MARK",
        "middle_name": "PATRICK",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-06-10",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MN",
            "license": "D12953",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Deborah Kafitz Smith, AUD, MA, CC-A
• Olivia Lynne Smith
• Solven Services LLC
• Preyia Sookram
• Shelby Kae Soule
• Spectrum High School
• Annemarie Kay Spence
• Kaitlyn Noel Sporre
• Cody Springer
• Paige Springer

• General Practice Dentistry in Elk River, MN
• Providers in Elk River, MN by specialty
• General Practice Dentistry in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.