Caroynn E.H. Spandau D.D.S.

Primary specialty

DentistTaxonomy code 122300000X

License

8267 Issued in IN

Legal business name

CAROYNN E.H. SPANDAU D.D.S.

Practice address

1030 Country Club Rd
Indianapolis, IN 46234-1813

Phone

(317) 271-2783

NPI assigned

Sep 26, 2007

Organization subpart

No

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

Authorized official

Name

Mrs. Carolynn E.H. Spandau

Title

Owner

Phone

(317) 271-1488

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1190764800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1190764800000",
    "number": "1699962472",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1030 COUNTRY CLUB RD",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462341813",
            "telephone_number": "317-271-2783"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1030 COUNTRY CLUB RD",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462341813",
            "telephone_number": "317-271-2783"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAROYNN E.H. SPANDAU D.D.S.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-26",
        "last_updated": "2007-09-26",
        "status": "A",
        "authorized_official_last_name": "SPANDAU",
        "authorized_official_first_name": "CAROLYNN",
        "authorized_official_middle_name": "E.H.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "317-271-1488",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "IN",
            "license": "8267",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Dentist in Indianapolis, IN
• Providers in Indianapolis, IN by specialty
• Dentist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 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.