Marisa J Clifford, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

052962-1 Issued in NY

Practice address

139 N Main St
Cortland, NY 13045

Phone

(607) 753-0602

Fax

(607) 758-8737

NPI assigned

Nov 25, 2006

Last updated

Jul 22, 2014By the provider in NPPES

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

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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

• Stuart R Douglas DMD PLLC

  • Dentist
  • Cortland, NY
  • NPI 1407941685
  NPD (past)

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

{
    "created_epoch": "1164412800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1405987200000",
    "number": "1124194998",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "139 N MAIN ST",
            "city": "CORTLAND",
            "state": "NY",
            "postal_code": "13045",
            "telephone_number": "607-753-0602",
            "fax_number": "607-758-8737"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "139 N MAIN ST",
            "city": "CORTLAND",
            "state": "NY",
            "postal_code": "13045",
            "telephone_number": "607-753-0602",
            "fax_number": "607-758-8737"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLIFFORD",
        "first_name": "MARISA",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-25",
        "last_updated": "2014-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "052962-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "201485764MD",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02784105",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Andrew S Chernow, DPM
• Ronald Edward Chrysler II
• Ashley Nicole Clair
• Kristin Clark-Lowell, D.M.D.
• Catherine J Clark, LPN
• Michele E Clukey, MS, CCC-SLP
• Jenniferleigh Vonderhorst Clune, FNP
• CMH Services, Inc (Cortland Regional Home Health Services)
• Kelli Cobb
• Matthew Cochran Sr., CRPA

• General Practice Dentistry in Cortland, NY
• Providers in Cortland, NY by specialty
• General Practice Dentistry in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2014; 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.