Individual provider Active NPI

Richard Oliver Spencer, D.D.S.

  • General Practice Dentistry
  • Fresno, CA
National Provider Identifier
1821135385
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
25992 Issued in CA
Practice address
347 E Barstow Ave
Suite 102
Fresno, CA 93710-6039
Phone
(559) 222-7789
Fax
(559) 222-8761
NPI assigned
Jan 31, 2007
Sex
Male
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
General Practice Dentistry 1223G0001X 25992 CA Primary

Addresses

Primary practice location

347 E Barstow Ave
Suite 102
Fresno, CA 93710-6039

Mailing address

347 E Barstow Ave
Suite 102
Fresno, CA 93710-6039
Phone (559) 222-7789

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20130520000739 CA Practitioner - Oral Surgery 8820236417 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Vallarine Dental, LLC CurrentSince Mar 1, 2013 Accepting new patients

Locations

2828 Fresno St
Ste 100
Fresno, CA 93721
Phone (559) 263-9648

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1170201600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1821135385",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "347 E BARSTOW AVE",
            "address_2": "SUITE 102",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937106039",
            "telephone_number": "559-222-7789",
            "fax_number": "559-222-8761"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "347 E BARSTOW AVE",
            "address_2": "SUITE 102",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937106039",
            "telephone_number": "559-222-7789",
            "fax_number": "559-222-8761"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPENCER",
        "first_name": "RICHARD",
        "middle_name": "OLIVER",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-31",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "25992",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fresno, CA

Sources for this page

Verify at the official NPI Registry.