Mark a Clemens DDS PA

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

6921 Issued in KS

Legal business name

MARK A CLEMENS DDS PA

Practice address

502 Shawnee St
Leavenworth, KS 66048-1957

Phone

(913) 651-2115

Fax

(913) 682-1218

NPI assigned

May 8, 2007

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Mark A Clemens, DDSNPI 1013019694

Title

President

Phone

(913) 651-2115

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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.

• Mark Alan Clemens, DDS

  • Dentist
  • Leavenworth, KS
  • NPI 1013019694
  Authorized official Same address or phone

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

{
    "created_epoch": "1178582400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1285847897",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "502 SHAWNEE ST",
            "city": "LEAVENWORTH",
            "state": "KS",
            "postal_code": "660481957",
            "telephone_number": "913-651-2115",
            "fax_number": "913-682-1218"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "502 SHAWNEE ST",
            "city": "LEAVENWORTH",
            "state": "KS",
            "postal_code": "660481957",
            "telephone_number": "913-651-2115",
            "fax_number": "913-682-1218"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARK A CLEMENS DDS PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-08",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "CLEMENS",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "913-651-2115",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "KS",
            "license": "6921",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dana C. Malis Sails, MD
• Jason R Malousek, PSYD, LP
• Bridget Mance, LMT
• Jarod Joseph Marcotte, PA-C
• Diane Elaine Margolies, LMFT
• Dorothy F Marsh, LCMFT
• Christopher Allen Marshall, AGNP
• Suzanne K Marske, CRNA
• Brett Alan Martin, MD
• Christina Marie Martin, OTR

• General Practice Dentistry in Leavenworth, KS
• Providers in Leavenworth, KS by specialty
• General Practice Dentistry in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.