Provider Demographics
NPI:1043204027
Name:SPERA, JOSEPH F (DMD)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:F
Last Name:SPERA
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2101 FOULK RD
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19810-4710
Mailing Address - Country:US
Mailing Address - Phone:302-475-1122
Mailing Address - Fax:302-475-1151
Practice Address - Street 1:2101 FOULK RD
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19810-4710
Practice Address - Country:US
Practice Address - Phone:302-475-1122
Practice Address - Fax:302-475-1151
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-07
Last Update Date:2012-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DE11581223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE1000032546OtherDELAWARE PHYS CARE INC
DE0001189701OtherDIAMOND STATE
DE2843429OtherAETNA
DE177496OtherCOVENTRY
DE0001189701Medicaid
DE731651766OtherBCBS OF DE
731651766OtherDELTA DENTAL
731651766OtherGUARDIAN DENTAL
731651766OtherDELTA DENTAL
DEG01019Medicare ID - Type Unspecified
DE0001189701Medicaid