Michael Spoelstra, D.D.S.

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

2901021245 Issued in MI

Practice address

Naval Health Clinic Hawaii
480 Central Avenue
Pearl Harbor, HI 96860

Phone

(517) 435-9914

NPI assigned

Dec 2, 2014

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1417478400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664496000000",
    "number": "1861899163",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "NAVAL HEALTH CLINIC HAWAII",
            "address_2": "480 CENTRAL AVENUE",
            "city": "PEARL HARBOR",
            "state": "HI",
            "postal_code": "96860"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "NAVAL HEALTH CLINIC HAWAII",
            "address_2": "480 CENTRAL AVENUE",
            "city": "PEARL HARBOR",
            "state": "HI",
            "postal_code": "96860",
            "telephone_number": "517-435-9914"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPOELSTRA",
        "first_name": "MICHAEL",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-12-02",
        "last_updated": "2022-09-30",
        "certification_date": "2022-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MI",
            "license": "2901021245",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "MI",
            "license": "2901021245",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jessica Singleton, DDS
• Whitney Aiko Smith, DDS
• Fawn Roegene Snow, RN
• Amy Katharyn Snyder, R.N.
• Craig Randolph Soleim, NAVY IDC
• Heather Lynn Stein, DMD, MS
• Taylor Anne Stubblefield, IDC
• Edwin Ernest Stumpf II, RN, CCM
• Cherryl Nobuko Sugimoto, PHARM.D., M.B.A.
• Celia Green Sukon, PA

• Oral and Maxillofacial Surgery (Dentist) in Pearl Harbor, HI
• Providers in Pearl Harbor, HI by specialty
• Oral and Maxillofacial Surgery (Dentist) in Hawaii

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2022; 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.