Charles Melvyn Spatz, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

4296 Issued in CT

Practice address

1574 Chapel Street
New Haven, CT 06511-4205

Phone

(203) 865-1480

Fax

(203) 865-0290

NPI assigned

Feb 5, 2007

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

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1170633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1359331200000",
    "number": "1972642023",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1574 CHAPEL STREET",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065114205",
            "telephone_number": "203-865-1480",
            "fax_number": "203-865-0290"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1574 CHAPEL STREET",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065114205",
            "telephone_number": "203-865-1480",
            "fax_number": "203-865-0290"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPATZ",
        "first_name": "CHARLES",
        "middle_name": "MELVYN",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-05",
        "last_updated": "2013-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CT",
            "license": "4296",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CT",
            "license": "4296",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8034743",
            "state": "CT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2042968",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Shahhan Spall, MD
• Lauren Kay Spangler, PA-C
• Stephanie S. Spangler, M.D.
• Marisa Nicole Spann, PHD
• Devika Dhandapani Sparks, MD
• Erica Sarah Spatz, M.D.
• Richard Spears
• Larry Neil Spector, O.D.
• Marcelo Spector, MD
• Fallon Marie Speers

• General Practice Dentistry in New Haven, CT
• Providers in New Haven, CT by specialty
• General Practice Dentistry in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2013; 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.