Mary H Clifford, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

MC016122 Issued in MI

Practice address

989 W Washington St Ste 104
Marquette, MI 49855-4073

Phone

(906) 226-9992

Fax

(906) 226-9982

NPI assigned

Oct 2, 2006

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 and National Provider Directory roles.

• Marquette County Health Department Dental Clinic

  • General Practice Dentistry
  • Marquette, MI
  • NPI 1922212901

  General Practice

  NPD (past)

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

{
    "created_epoch": "1159747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1205929247",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "989 W WASHINGTON ST STE 104",
            "city": "MARQUETTE",
            "state": "MI",
            "postal_code": "498554073",
            "telephone_number": "906-226-9992",
            "fax_number": "906-226-9982"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "989 W WASHINGTON ST STE 104",
            "city": "MARQUETTE",
            "state": "MI",
            "postal_code": "498554073",
            "telephone_number": "906-226-9992",
            "fax_number": "906-226-9982"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLIFFORD",
        "first_name": "MARY",
        "middle_name": "H",
        "name_prefix": "Ms.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-02",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "MC016122",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DELTA DENTAL PROVIDER NUM",
            "identifier": "88131",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PROVIDER NUMBER",
            "identifier": "D801057",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Denise Clark
• Dexter D Clark, DO
• Suzanne Marie Clarke, MD
• Brian William Claus, AT, ATC, CSCS
• Mariah Ellen Clement
• Alexander W Cline, BT
• Gloria J Clocklin, FNP
• Christianna Close, MAE-BCBA
• Craig T Coccia, MD
• Christianne Lenett Collins, NP

• All providers in Marquette, MI
• General Practice Dentistry in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 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.

Verify at the official NPI Registry.