Clinton Thomas Ambroson, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

08908 Issued in IA

Practice address

104 E Washington St
Clarinda, IA 51632-1611

Phone

(712) 542-5196

NPI assigned

May 15, 2012

Sex

Male

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 IA

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

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.

• Clarinda Family Dentistry PLLC

  • General Practice Dentistry
  • Clarinda, IA
  • NPI 1518667005
  NPD (past)

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

{
    "created_epoch": "1337040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1340928000000",
    "number": "1164781829",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "302 W NISHNA ST",
            "city": "CLARINDA",
            "state": "IA",
            "postal_code": "516321000",
            "telephone_number": "319-321-4082"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 E WASHINGTON ST",
            "city": "CLARINDA",
            "state": "IA",
            "postal_code": "516321611",
            "telephone_number": "712-542-5196"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AMBROSON",
        "first_name": "CLINTON",
        "middle_name": "THOMAS",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-05-15",
        "last_updated": "2012-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IA",
            "license": "08908",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Katie Louise Abold, LMHC
• Air Evac EMS, Inc. (Air Evac Lifeteam)
• Anchor Homes, Inc
• Debra Lynn Arbuckle, SWML
• Assisted Living Concepts Inc (Eiler House)
• Vickie Lynne Auten, R.N.
• Melisa S. Baier, RD, LD

• Dentist in Clarinda, IA
• Providers in Clarinda, IA by specialty
• Dentist in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2012; 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.