1720144421 NPI number — ROBERT ANDREW SPENCE D.D.S., P.C.

NPI Number: 1720144421
Health Care Provider/Practitioner: ROBERT ANDREW SPENCE D.D.S., P.C.

NPI Number : 1720144421 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1720144421",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "Y",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "SPENCE",
    "FirstName": "ROBERT",
    "MiddleName": "ANDREW",
    "NamePrefix": "DR.",
    "NameSuffix": null,
    "Credential": "D.D.S., P.C.",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "3226 N MILLER RD",
    "SecondLineMailingAddress": "SUITE 2",
    "MailingAddressCityName": "SCOTTSDALE",
    "MailingAddressStateName": "AZ",
    "MailingAddressPostalCode": "85251-6930",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "480-949-8564",
    "MailingAddressFaxNumber": "480-949-0267",
    "FirstLinePracticeLocationAddress": "3226 N MILLER RD",
    "SecondLinePracticeLocationAddress": "SUITE 2",
    "PracticeLocationAddressCityName": "SCOTTSDALE",
    "PracticeLocationAddressStateName": "AZ",
    "PracticeLocationAddressPostalCode": "85251-6930",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "480-949-8564",
    "PracticeLocationAddressFaxNumber": "480-949-0267",
    "EnumerationDate": "12/28/2006",
    "LastUpdateDate": "07/08/2007",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "M",
    "Gender": "Male",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "1223G0001X",
        "TaxonomyName": "General Practice Dentistry",
        "LicenseNumber": "D1430",
        "LicenseNumberStateCode": "AZ",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}