Active NPI
Eric Spurgeon, DDS
- Dentist
- Waterloo, IA
National Provider Identifier
1962816587
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- DDS-09084
- Practice address
- 905 Franklin St
Waterloo, IA 50703-4407 - Phone
- (319) 272-4300
- NPI assigned
- Jun 12, 2014
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | DDS-09084 | IA | Primary |
Addresses
Primary practice location
905 Franklin St
Waterloo, IA 50703-4407
Mailing address
905 Franklin St
Waterloo, IA 50703-4407
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0076372 | Medicaid | IA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DDS-09084 | IA | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Aria Dental Care PC | Dentist | Current | Accepting new patients |
Locations
400 Locust St
Ste 400
Des Moines, IA 50309
Phone (515) 664-2681
8500 W 110th St
Ste 450
Overland Park, KS 66210
Phone (913) 362-1112
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": "1402531200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1402531200000",
"number": "1962816587",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "905 FRANKLIN ST",
"city": "WATERLOO",
"state": "IA",
"postal_code": "507034407"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "905 FRANKLIN ST",
"city": "WATERLOO",
"state": "IA",
"postal_code": "507034407",
"telephone_number": "319-272-4300"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SPURGEON",
"first_name": "ERIC",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2014-06-12",
"last_updated": "2014-06-12",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "IA",
"license": "DDS-09084",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0076372",
"state": "IA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Waterloo, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.