Jonathan Christopher Clemetson, D. D. S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

21234 Issued in TX

Practice address

1700 Pacific Ave
Suite 260
Dallas, TX 75201-4617

Phone

(214) 651-0005

Fax

(214) 651-1419

NPI assigned

Aug 4, 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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in TX

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

Medicare enrollment (NPD)

Enrolled

State licenses

Interoperability endpoints

• Direct secure messaging: jonathan.clemetson.1@17923.direct.athenahealth.com

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

{
    "created_epoch": "1154649600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1231286400000",
    "number": "1316955107",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7416 CORONADO AVE",
            "address_2": "APT. 6",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752145834",
            "telephone_number": "214-324-5468"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 PACIFIC AVE",
            "address_2": "SUITE 260",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752014617",
            "telephone_number": "214-651-0005",
            "fax_number": "214-651-1419"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLEMETSON",
        "first_name": "JONATHAN",
        "middle_name": "CHRISTOPHER",
        "name_prefix": "Dr.",
        "credential": "D. D. S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-04",
        "last_updated": "2009-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "21234",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "163530201",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Keri Lee Clements, MSN, RN, AGACNP-BC
• Lauri Clements, AGPCNP-BC
• Nicole Essley Clements, OTR
• Roy Rance Clements III, D.C.
• Vanesa Guerra Clements, DDS
• Melanie Clemmer, RD, CDE
• Calvin Anquan Clemmons
• Irene Clemons
• Matthew Paul Clemons, MD
• Teresa L Clemons, ANP

• General Practice Dentistry in Dallas, TX
• Providers in Dallas, TX by specialty
• General Practice Dentistry in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2009; 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.