Individual provider Active NPI

Robert Lee Clitheroe, DDS

  • Dentist
  • Sugar Land, TX
National Provider Identifier
1184647448
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
14736 Issued in TX
Practice address
1716 Dulles Ave Ste 101
Sugar Land, TX 77478-5358
Phone
(281) 265-9393
NPI assigned
Jul 26, 2006
Sex
Male
Sole proprietor
Yes

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
Dentist 122300000X 14736 TX Primary

Addresses

Primary practice location

1716 Dulles Ave Ste 101
Sugar Land, TX 77478-5358

Mailing address

1716 Dulles Ave Ste 101
Sugar Land, TX 77478-5358

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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

Enrollment IDStateProvider typePAC IDDetails
I20160204001523 TX Order and Referring Only - DentistPractitioner - Dentist 2769786144

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1153872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1184647448",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1716 DULLES AVE STE 101",
            "city": "SUGAR LAND",
            "state": "TX",
            "postal_code": "774785358"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1716 DULLES AVE STE 101",
            "city": "SUGAR LAND",
            "state": "TX",
            "postal_code": "774785358",
            "telephone_number": "281-265-9393"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLITHEROE",
        "first_name": "ROBERT",
        "middle_name": "LEE",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TX",
            "license": "14736",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sugar Land, TX

Sources for this page

Verify at the official NPI Registry.