1891577359 NPI number — WILLIAM Z. SPATZ DMD, P.C.

Table of content: DR. MARIA MISCHELLE CASIANO M.D. (NPI 1770711129)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1891577359 NPI number — WILLIAM Z. SPATZ DMD, P.C.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
WILLIAM Z. SPATZ DMD, P.C.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1891577359
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/19/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2001 WATERDAM PLAZA DR STE 203
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MC MURRAY
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
15317-5416
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
724-940-6884
Provider Business Mailing Address Fax Number:
724-841-6885

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2001 WATERDAM PLAZA DR STE 203
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MC MURRAY
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15317-5416
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
724-940-6884
Provider Business Practice Location Address Fax Number:
724-841-6885
Provider Enumeration Date:
10/19/2023

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
GARCIA ROCHA
Authorized Official First Name:
JENNY
Authorized Official Middle Name:
Authorized Official Title or Position:
SR CREDENTIALING TEAM LEAD
Authorized Official Telephone Number:
972-869-3789

Provider Taxonomy Codes

  • Taxonomy code: 1223G0001X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)