Amanda Clemons, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

12012799A Issued in IN

Practice address

1002 N Mitthoeffer Rd Ste B
Indianapolis, IN 46229-2461

Phone

(317) 898-6666

NPI assigned

Jul 31, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Eastpointe Family Dentistry, LLC

  • General Practice Dentistry
  • Indianapolis, IN
  • NPI 1801649637
  NPD Authorized official
• Pulos Family Dentistry, LLC

  • General Practice Dentistry
  • Indianapolis, IN
  • NPI 1972016392
  NPD (past)

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

{
    "created_epoch": "1501459200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1501459200000",
    "number": "1114441383",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1002 N MITTHOEFFER RD STE B",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462292461"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1002 N MITTHOEFFER RD STE B",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462292461",
            "telephone_number": "317-898-6666"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLEMONS",
        "first_name": "AMANDA",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-07-31",
        "last_updated": "2017-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IN",
            "license": "12012799A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Peter Luke Clements
• Richa Clements, LSW
• Robert E Clements, MD
• Sydney Lynn Clements
• Madeleine Elise Clemmer
• Tarita Clemons
• Katherine Jo Clendenen, LMHC
• Jennifer Cleveland, RD, CDE
• Melissa Rae Cleveland, PNP
• Vicki A Cleveland, APRN BC

• Dentist in Indianapolis, IN
• Providers in Indianapolis, IN by specialty
• Dentist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.