Howard Russell Spruill III, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DS042953 Issued in PA

Practice address

4736 Neshaminy Blvd
Bensalem, PA 19020-1038

Phone

(215) 750-9955

NPI assigned

Jun 21, 2016

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

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": "1466467200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726531200000",
    "number": "1952751950",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 FAIRFIELD LN",
            "city": "HILLSBOROUGH",
            "state": "NJ",
            "postal_code": "088441716",
            "telephone_number": "908-642-1067"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4736 NESHAMINY BLVD",
            "city": "BENSALEM",
            "state": "PA",
            "postal_code": "190201038",
            "telephone_number": "215-750-9955"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 Robert Wood Johnson Pl",
            "address_2": "Ambulatory Services, Suite D",
            "address_purpose": "LOCATION",
            "city": "New Brunswick",
            "state": "NJ",
            "postal_code": "089011928",
            "country_code": "US",
            "telephone_number": "732-937-8653",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SPRUILL",
        "first_name": "HOWARD",
        "middle_name": "RUSSELL",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-06-21",
        "last_updated": "2024-09-17",
        "certification_date": "2024-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NJ",
            "license": "22DI0263900",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "PA",
            "license": "DS042953",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "PA",
            "license": "DS042953",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2024; 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.