Individual provider Active NPI

Ashby Paige Clanton, DDS

  • General Practice Dentistry
  • Johnson City, TN
National Provider Identifier
1215053806
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DS0000004223 Issued in TN
Practice address
1301 Sunset Dr
Suite 1
Johnson City, TN 37604-7906
Phone
(423) 929-7146
Fax
(423) 232-2812
NPI assigned
Mar 22, 2007
Sex
Female
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
General Practice Dentistry 1223G0001X DS0000004223 TN Primary

Addresses

Primary practice location

1301 Sunset Dr
Suite 1
Johnson City, TN 37604-7906

Mailing address

1301 Sunset Dr
Suite 1
Johnson City, TN 37604-7906
Phone (423) 929-7146

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
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
I20150710002631 TN Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 2769794296

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DS0000004223TNMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1174521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1215053806",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1301 SUNSET DR",
            "address_2": "SUITE 1",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376047906",
            "telephone_number": "423-929-7146",
            "fax_number": "423-232-2812"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 SUNSET DR",
            "address_2": "SUITE 1",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376047906",
            "telephone_number": "423-929-7146",
            "fax_number": "423-232-2812"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLANTON",
        "first_name": "ASHBY",
        "middle_name": "PAIGE",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-22",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TN",
            "license": "DS0000004223",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Johnson City, TN

Sources for this page

Verify at the official NPI Registry.