Active NPI
Jill Kathryn McLean, DDS
- Dentist
- Bethel, AK
National Provider Identifier
1144341660
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- DD5790
- Practice address
- 829 Chief Eddie Hoffman Hwy
Bethel, AK 98862 - Phone
- (907) 543-6229
- NPI assigned
- Apr 2, 2007
- Reactivated
- Aug 10, 2007
- Last updated
- Aug 10, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | DD5790 | AK | Primary |
Addresses
Primary practice location
829 Chief Eddie Hoffman Hwy
Bethel, AK 98862
Mailing address
Box 525
Dental Dept
Bethel, AK 98862
Phone (907) 543-6229
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| DD5790 | Medicaid | AK |
Other names 1
- Jill McLean Calvert
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
| License | State | Type | Specialty |
|---|---|---|---|
| DD5790 | AK | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1175472000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1186704000000",
"number": "1144341660",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "BOX 525",
"address_2": "DENTAL DEPT",
"city": "BETHEL",
"state": "AK",
"postal_code": "98862",
"telephone_number": "907-543-6229"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "829 CHIEF EDDIE HOFFMAN HWY",
"city": "BETHEL",
"state": "AK",
"postal_code": "98862",
"telephone_number": "907-543-6229"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCLEAN",
"first_name": "JILL",
"middle_name": "KATHRYN",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-04-02",
"last_updated": "2007-08-10",
"deactivation_date": "2007-07-17",
"reactivation_date": "2007-08-10",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "AK",
"license": "DD5790",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "DD5790",
"state": "AK"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "JILL",
"last_name": "CALVERT",
"middle_name": "MCLEAN",
"code": "2",
"type": "Professional Name"
}
]
}Other providers in Bethel, AK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 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.