NPIMap

Organization Active NPI

Clark Clements Dental PLLC

  • General Practice Dentistry
  • Shelbyville, TN
National Provider Identifier
1205257599
Registry record updated Jan 3, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
3046 Issued in TN
Legal business name
CLARK CLEMENTS DENTAL PLLC
Practice address
710 N Brittain St
Ste C
Shelbyville, TN 37160-3448
Phone
(931) 685-9700
Fax
(931) 685-4051
NPI assigned
Jan 3, 2014
Last updated
Jan 3, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 3, 2014

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

Authorized official

Name
Mrs. Cindy G Birdsong
Title
Office Manager
Phone
(931) 685-9700

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223G0001X 3046 TN Primary
General Practice DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223G0001X 9671 TN

Addresses

Primary practice location

710 N Brittain St
Ste C
Shelbyville, TN 37160-3448

Mailing address

710 N Brittain St
Ste C
Shelbyville, TN 37160-3448
Phone (931) 685-9700

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1388707200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1388707200000",
    "number": "1205257599",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "710 N BRITTAIN ST",
            "address_2": "STE C",
            "city": "SHELBYVILLE",
            "state": "TN",
            "postal_code": "371603448",
            "telephone_number": "931-685-9700",
            "fax_number": "931-685-4051"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "710 N BRITTAIN ST",
            "address_2": "STE C",
            "city": "SHELBYVILLE",
            "state": "TN",
            "postal_code": "371603448",
            "telephone_number": "931-685-9700",
            "fax_number": "931-685-4051"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLARK CLEMENTS DENTAL PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-01-03",
        "last_updated": "2014-01-03",
        "status": "A",
        "authorized_official_last_name": "BIRDSONG",
        "authorized_official_first_name": "CINDY",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "931-685-9700",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "TN",
            "license": "3046",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "TN",
            "license": "9671",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shelbyville, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 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.