Individual provider Active NPI

Edward Allen Spiro, DDS

  • Dentist
  • Wantagh, NY
National Provider Identifier
1740326354
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
31358 Issued in NY
Practice address
12 Red Maple Drive North
Wantagh, NY 11793
Phone
(516) 731-5240
Fax
(516) 735-8442
NPI assigned
Jan 30, 2007
Sex
Male
Sole proprietor
No

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 31358 NY Primary

Addresses

Primary practice location

12 Red Maple Drive North
Wantagh, NY 11793

Mailing address

12 Red Maple Drive North
Wantagh, NY 11793
Phone (516) 731-5240

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20150917002488 NY Order and Referring Only - DentistPractitioner - Dentist 6800103136

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
31358NYMDDentist
031358NYMDPhysician Assistant

NPI Registry JSON

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

{
    "created_epoch": "1170115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1740326354",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12 RED MAPLE DRIVE NORTH",
            "city": "WANTAGH",
            "state": "NY",
            "postal_code": "11793",
            "telephone_number": "516-731-5240",
            "fax_number": "516-735-8442"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12 RED MAPLE DRIVE NORTH",
            "city": "WANTAGH",
            "state": "NY",
            "postal_code": "11793",
            "telephone_number": "516-731-5240",
            "fax_number": "516-735-8442"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPIRO",
        "first_name": "EDWARD",
        "middle_name": "ALLEN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-30",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "31358",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wantagh, NY

Sources for this page

Verify at the official NPI Registry.