{"npi":"1578732467","type":"NPI-1","status":"active","name":{"display":"Dr. Spencer Wagner D.M.D","other":[],"first":"SPENCER","last":"WAGNER","middle":"B","credential":"D.M.D"},"specialty":{"primary_taxonomy":"122300000X","primary_taxonomy_description":"Dentist","slug":"dentist","schema_org_specialty":null,"all":[{"code":"122300000X","description":"Dentist","primary":true,"state":"SC","license":"3192"},{"code":"122300000X","description":"Dentist","primary":false,"state":"UT","license":"6026130"}]},"addresses":[{"purpose":"LOCATION","street_1":"2520 N UNIVERSITY AVE","city":"PROVO","state":"UT","postal_code":"846043804","country_code":"US","street_2":"SUITE 101","phone":"8014266255","fax":"8012242966"},{"purpose":"MAILING","street_1":"2520 N UNIVERSITY AVE","city":"PROVO","state":"UT","postal_code":"846043804","country_code":"US","street_2":"SUITE 101","phone":"8014266255","fax":"8012242966"}],"license":{"state":"SC","number":"3192"},"identifiers":[{"type_code":"05","label":"Medicaid","value":"Z31920","state":"NC","issuer":null}],"pecos":{"enrolled_at":"2026-05-09T10:41:39.028268+00:00","enrollments":[{"enrlmt_id":"I20160218001000","type_code":"33-19","type_desc":"ORDER AND REFERRING ONLY - ORAL SURGERY","state":"SC","pac_id":"1557666211"}]},"enumeration_date":"2008-02-25","last_updated":"2013-01-04","_meta":{"source":"NPPES","snapshot_date":"2013-01-04","doc_url":"https://findmynpi.com/api"}}