Provider Demographics
NPI:1588615108
Name:SPINGOLA, DEAN B (DMD, MD)
Entity Type:Individual
Prefix:DR
First Name:DEAN
Middle Name:B
Last Name:SPINGOLA
Suffix:
Gender:M
Credentials:DMD, MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:440 W INTERSTATE HWY 635
Mailing Address - Street 2:SUITE 445
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75063-3811
Mailing Address - Country:US
Mailing Address - Phone:972-401-8301
Mailing Address - Fax:972-444-8265
Practice Address - Street 1:440 W INTERSTATE HWY 635
Practice Address - Street 2:SUITE 445
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75063-3811
Practice Address - Country:US
Practice Address - Phone:972-401-8301
Practice Address - Fax:972-444-8265
Is Sole Proprietor?:No
Enumeration Date:2006-05-16
Last Update Date:2008-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL12081223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
U82392Medicare UPIN
TX008228M0Medicare PIN