Organization Active NPI

McLean Dental Group

  • General Practice Dentistry
  • South Burlington, VT
National Provider Identifier
1013286376
Registry record updated Dec 15, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
016.0002101 Issued in VT
Legal business name
MCLEAN DENTAL GROUP
Practice address
1683 Williston Rd
Suite 1
South Burlington, VT 05403-6426
Phone
(802) 864-9111
NPI assigned
Dec 15, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 15, 2011

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. David E McLean, DDSNPI 1588685259
Title
Owner/ President
Phone
(802) 864-9111

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 016.0002101 VT Primary

Addresses

Primary practice location

1683 Williston Rd
Suite 1
South Burlington, VT 05403-6426

Mailing address

1683 Williston Rd
Suite 1
South Burlington, VT 05403-6426
Phone (802) 864-9111

Other identifiers 1

IdentifierTypeStateIssuer
1007358MedicaidVT

National Provider Directory

National Provider Directory

Locations

1683 Williston Rd
#1
South Burlington, VT 05403
Phone (802) 864-9111

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1323907200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1323907200000",
    "number": "1013286376",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1683 WILLISTON RD",
            "address_2": "SUITE 1",
            "city": "SOUTH BURLINGTON",
            "state": "VT",
            "postal_code": "054036426",
            "telephone_number": "802-864-9111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1683 WILLISTON RD",
            "address_2": "SUITE 1",
            "city": "SOUTH BURLINGTON",
            "state": "VT",
            "postal_code": "054036426",
            "telephone_number": "802-864-9111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MCLEAN DENTAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-12-15",
        "last_updated": "2011-12-15",
        "status": "A",
        "authorized_official_last_name": "MCLEAN",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "OWNER/ PRESIDENT",
        "authorized_official_telephone_number": "802-864-9111",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "VT",
            "license": "016.0002101",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1007358",
            "state": "VT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in South Burlington, VT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.