Provider Demographics
NPI:1386787935
Name:SPILMAN, JEFFERY ALAN (DDS)
Entity type:Individual
Prefix:DR
First Name:JEFFERY
Middle Name:ALAN
Last Name:SPILMAN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 WINSTON DR
Mailing Address - Street 2:
Mailing Address - City:BELLEAIR
Mailing Address - State:FL
Mailing Address - Zip Code:33756-1646
Mailing Address - Country:US
Mailing Address - Phone:727-586-3207
Mailing Address - Fax:727-586-2554
Practice Address - Street 1:4899 5TH AVE N
Practice Address - Street 2:
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33713-7217
Practice Address - Country:US
Practice Address - Phone:727-321-1427
Practice Address - Fax:727-328-1185
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-14
Last Update Date:2022-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN 162211223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice