Provider Demographics
NPI:1598103616
Name:SPENDLOVE, NIKLAUS ARTHUR (DMD)
Entity Type:Individual
Prefix:
First Name:NIKLAUS
Middle Name:ARTHUR
Last Name:SPENDLOVE
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 1:1134 SUNBURST WAY
Mailing Address - Street 2:
Mailing Address - City:GRANTS PASS
Mailing Address - State:OR
Mailing Address - Zip Code:97526-6352
Mailing Address - Country:US
Mailing Address - Phone:801-791-4116
Mailing Address - Fax:541-504-3907
Practice Address - Street 1:1100 NE 7TH ST STE B
Practice Address - Street 2:
Practice Address - City:GRANTS PASS
Practice Address - State:OR
Practice Address - Zip Code:97526-1415
Practice Address - Country:US
Practice Address - Phone:541-476-4667
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-06-11
Last Update Date:2022-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORD98711223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice