Individual provider Active NPI

John Anderson Clinebell, DDS,MS

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Decatur, GA
National Provider Identifier
1033608971
Registry record updated May 7, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
License
DN010537 Issued in GA
Practice address
3732 Lavista Rd
Decatur, GA 30033-1006
Phone
(404) 325-8116
Fax
(404) 325-0417
NPI assigned
May 7, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 7, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X DN010537 GA Primary

Addresses

Primary practice location

3732 Lavista Rd
Decatur, GA 30033-1006

Mailing address

3732 Lavista Rd
Decatur, GA 30033-1006
Phone (404) 325-8116

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
DN010537GAMDOrthodontics and Dentofacial Orthopedic Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
John a. Clinebell, D.D.S., M.S., P.C. Orthodontics and Dentofacial Orthopedics Current Accepting new patients
Clinebell and Anderson Orthodontics Orthodontics and Dentofacial Orthopedics CurrentSince Sep 11, 2022 Accepting new patients

Locations

3732 Lavista Rd
Decatur, GA 30033
Phone (404) 325-8116

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1525651200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1525651200000",
    "number": "1033608971",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3732 LAVISTA RD",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300331006",
            "telephone_number": "404-325-8116",
            "fax_number": "404-325-0417"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3732 LAVISTA RD",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300331006",
            "telephone_number": "404-325-8116",
            "fax_number": "404-325-0417"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLINEBELL",
        "first_name": "JOHN",
        "middle_name": "ANDERSON",
        "name_prefix": "Dr.",
        "credential": "DDS,MS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-05-07",
        "last_updated": "2018-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "GA",
            "license": "DN010537",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Decatur, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2018; 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.