Michael David Clary, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DS3343 Issued in TN

Practice address

9217 Park West Blvd Ste F1
Knoxville, TN 37923-4422

Phone

(865) 693-7041

NPI assigned

Aug 26, 2006

Sex

Male

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1156550400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1245348739",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9217 PARK WEST BLVD STE F1",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379234422",
            "telephone_number": "865-693-7041"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9217 PARK WEST BLVD STE F1",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379234422",
            "telephone_number": "865-693-7041"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARY",
        "first_name": "MICHAEL",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TN",
            "license": "DS3343",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Steven Thomas Clark, MD
• Vina Cherayl Clark
• Abigail Carolyn Clarke, M.S. CCC-SLP
• Jodi Eleanor Clarke, MA, LPC/MHSP, NCC
• Clarksville Home Care Services LLC (SunCrest Hospice)
• Claude C. Frazier III
• Claude C. Frazier, III, DO
• Eric J Clausen, CRNA
• Karen G Clawson, D.PH.
• Claxton Dietetic Solutions, LLC

• General Practice Dentistry in Knoxville, TN
• Providers in Knoxville, TN by specialty
• General Practice Dentistry in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.