Dr Jordan Mitchell Spavor, DDS is a medicare enrolled "Dentist" provider in Lawrence, Michigan. His current practice location is
260 South St, Lawrence, Michigan. You can reach out to his office (for appointments etc.) via phone at
(269) 621-3143.
Dr Jordan Mitchell Spavor is licensed to practice in Michigan (license number 2901601054) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1043983562.
Healthcare Provider's Profile
Full Name | Dr Jordan Mitchell Spavor |
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Gender | Male |
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Speciality | Dentist |
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Location | 260 South St, Lawrence, Michigan |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1043983562
- Provider Enumeration Date: 07/29/2021
- Last Update Date: 07/29/2021
Medicare PECOS Information:
- PECOS PAC ID: 8628474681
- Enrollment ID: I20210831002100
Medical Identifiers
Medical identifiers for Dr Jordan Mitchell Spavor such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1043983562 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
122300000X | Dentist | 2901601054 (Michigan) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Jordan Mitchell Spavor is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Dr Jordan Mitchell Spavor, DDS 8022 Lake Wood Dr, Portage, MI 49002-5565 Ph: (313) 571-4008 | Dr Jordan Mitchell Spavor, DDS 260 South St, Lawrence, MI 49064-9325 Ph: (269) 621-3143 |
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