Individual provider Active NPI

Clifford Harold Jue, DDS

  • General Practice Dentistry
  • Fresno, CA
National Provider Identifier
1083774848
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
19230 Issued in CA
Practice address
125 E Barstow Ave
Suite 122
Fresno, CA 93710
Phone
(559) 227-5309
Fax
(559) 227-7934
NPI assigned
Dec 11, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 19230 CA Primary

Addresses

Primary practice location

125 E Barstow Ave
Suite 122
Fresno, CA 93710

Mailing address

125 E Barstow Ave
Suite 122
Fresno, CA 93710
Phone (559) 227-5309

Other identifiers 2

IdentifierTypeStateIssuer
B1923001OtherCADENTICAL STATE OF CA
19230OtherCASTATE OF CALIFORNIA

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

State licenses

LicenseStateTypeSpecialty
19230CAMDAcupuncturist

NPI Registry JSON

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

{
    "created_epoch": "1165795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1083774848",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 E BARSTOW AVE",
            "address_2": "SUITE 122",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "93710",
            "telephone_number": "559-227-5309",
            "fax_number": "559-227-7934"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 E BARSTOW AVE",
            "address_2": "SUITE 122",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "93710",
            "telephone_number": "559-227-5309",
            "fax_number": "559-227-7934"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JUE",
        "first_name": "CLIFFORD",
        "middle_name": "HAROLD",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-11",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "19230",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DENTICAL STATE OF CA",
            "identifier": "B1923001",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE OF CALIFORNIA",
            "identifier": "19230",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fresno, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.