Individual provider Active NPI

Kenneth J Spolnik, D.D.S.,M.S.D.

  • Endodontics
  • Indianapolis, IN
National Provider Identifier
1770523334
Registry record updated Dec 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
EndodonticsTaxonomy code 1223E0200X
License
12007275A Issued in IN
Practice address
3750 Guion Rd
Suite 280
Indianapolis, IN 46222-7602
Phone
(317) 924-3228
NPI assigned
Jun 8, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 22, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endodontics 1223E0200X 12007275A IN Primary

Addresses

Primary practice location

3750 Guion Rd
Suite 280
Indianapolis, IN 46222-7602

Mailing address

3750 Guion Rd
Suite 280
Indianapolis, IN 46222-7602
Phone (317) 924-3228

Other practice location 1

1121 W Michigan St
Indianapolis, IN 46202-5211
Phone (317) 274-7433

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20150108000405 IN Order and Referring Only - DentistPractitioner - Oral SurgeryPractitioner - Dentist 7315123254

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": "1149724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1766361600000",
    "number": "1770523334",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3750 GUION RD",
            "address_2": "SUITE 280",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462227602",
            "telephone_number": "317-924-3228"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3750 GUION RD",
            "address_2": "SUITE 280",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462227602",
            "telephone_number": "317-924-3228"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1121 W Michigan St",
            "address_purpose": "LOCATION",
            "city": "Indianapolis",
            "state": "IN",
            "postal_code": "462025211",
            "country_code": "US",
            "telephone_number": "317-274-7433",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SPOLNIK",
        "first_name": "KENNETH",
        "middle_name": "J",
        "credential": "D.D.S.,M.S.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-08",
        "last_updated": "2025-12-22",
        "certification_date": "2025-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "IN",
            "license": "12007275A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.