Individual provider Active NPI

Janice Elizabeth Spada, D.M.D.

  • Dentist
  • Sudbury, MA
National Provider Identifier
1730182791
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
15135 Issued in MA
Practice address
616 Boston Post Rd
Sudbury, MA 01776-3376
Phone
(978) 443-3111
NPI assigned
May 24, 2005
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 15135 MA Primary

Addresses

Primary practice location

616 Boston Post Rd
Sudbury, MA 01776-3376

Mailing address

616 Boston Post Rd
Sudbury, MA 01776-3376
Phone (978) 443-3111

Other identifiers 1

IdentifierTypeStateIssuer
X06898OtherMABLUE CROSS BLUE SHIELD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150306001449 MA Order and Referring Only - DentistPractitioner - Dentist 2668798794

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1116892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1730182791",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "616 BOSTON POST RD",
            "city": "SUDBURY",
            "state": "MA",
            "postal_code": "017763376",
            "telephone_number": "978-443-3111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "616 BOSTON POST RD",
            "city": "SUDBURY",
            "state": "MA",
            "postal_code": "017763376",
            "telephone_number": "978-443-3111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPADA",
        "first_name": "JANICE",
        "middle_name": "ELIZABETH",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-05-24",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MA",
            "license": "15135",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "X06898",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sudbury, MA

Sources for this page

Verify at the official NPI Registry.