SPENCER WADE NPI 1316396419

NPI Information

NPI: 1316396419
Provider Name: SPENCER WADE
Classification: Dentist - 1223D0004X
Entity Type: Individual

Specialization: Dentist Anesthesiologist

PECOS Registration: Yes

Address:
345 E 24TH ST
NEW YORK, NY
ZIP 10010
Phone: (517) 285-8734
Get Directions

Spencer Wade is a dentist anesthesiologist dentist in New York, NY. The provider is a dentist who has successfully completed an accredited postdoctoral anesthesiology residency training program for dentists of two or more years duration, in accord with Commission on Dental Accreditation's Standards for Dental Anesthesiology Residency Programs, and/or meets the eligibility requirements for examination by the American Dental Board of Anesthesiology. Spencer Wade NPI is 1316396419. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

345 E 24TH ST
NEW YORK, NY
ZIP 10010-020
Phone: (517) 285-8734

The NPI 1316396419 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 6/9/2016 and was last updated on 9/7/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	122300000X	Dentist		3705	OHIO	No
2	1223D0004X	Dentist	Dentist Anesthesiologist	10310	KENTUCKY	No
3	1223D0004X	Dentist	Dentist Anesthesiologist	O61371	NEW YORK	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	5172858734	OTHER	OHIO	THE OHIO STATE UNIVERSITY

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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