Phuong Quynh Ngoc Spicer, D.M.D.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DN015406 Issued in GA

Practice address

150-160 North Louisville Street
Harlem, GA 30814-5084

Phone

(706) 449-8352

Fax

(706) 449-8005

NPI assigned

Jun 3, 2017

Last updated

Feb 6, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Ms. Phuong Quynh Ngoc Le Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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.

• Harlem Family Dental

  • Dental Clinic/Center
  • Harlem, GA
  • NPI 1679127088
  NPD Authorized official
• Augusta Smiles Youth Dentistry, PC

  • General Practice Dentistry
  • Augusta, GA
  • NPI 1033184643
  NPD (past)
• Bridgeport River Dental PC

  • General Practice Dentistry
  • Augusta, GA
  • NPI 1346898293
  NPD (past)

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

{
    "created_epoch": "1496448000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675641600000",
    "number": "1790213700",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 850",
            "city": "HARLEM",
            "state": "GA",
            "postal_code": "308140850",
            "telephone_number": "706-449-8352",
            "fax_number": "706-449-8005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150-160 NORTH LOUISVILLE STREET",
            "city": "HARLEM",
            "state": "GA",
            "postal_code": "308145084",
            "telephone_number": "706-449-8352",
            "fax_number": "706-449-8005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPICER",
        "first_name": "PHUONG QUYNH",
        "middle_name": "NGOC",
        "name_prefix": "Mrs.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-03",
        "last_updated": "2023-02-06",
        "certification_date": "2023-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "GA",
            "license": "DN015406",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GEORGIA DENTAL LICENSE",
            "identifier": "DN015406",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "PHUONG QUYNH",
            "last_name": "LE",
            "middle_name": "NGOC",
            "prefix": "MS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Daniel Francis Massa, D.C.
• Brandyn J McComb
• Medctr Inc (Harlem Pharmacy)
• Denise D Silver, PT
• Southerland Clark Enterprises LLC (Academy Lifelong Learning (ALL))
• Ebony Nichole Story, PMHNP, APRN
• Brieanna Nicole Sturgis, DPT
• The Haven of Harlem
• West Forrest
• Arianna Williams, SA-C

• General Practice Dentistry in Harlem, GA
• Providers in Harlem, GA by specialty
• General Practice Dentistry in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2023; 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.