Barbara Agnes McLellan, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DN 13672 Issued in FL

Practice address

1100 S Ponce de Leon Blvd Ste 2
St Augustine, FL 32084-6013

Phone

(904) 829-6321

Fax

(904) 829-2338

NPI assigned

Sep 30, 2006

Sex

Female

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

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.

• McLellan Dental Inc.

  • Dentist
  • St Augustine, FL
  • NPI 1790920544
  NPD (past)
• Smiling Kidds Dentistry, P.a.

  • Pediatric Dentistry
  • Saint Augustine, FL
  • NPI 1881290211
  NPD (past)

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

{
    "created_epoch": "1159574400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1356434682",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 S PONCE DE LEON BLVD STE 2",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320846013",
            "telephone_number": "904-829-6321",
            "fax_number": "904-829-2338"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 S PONCE DE LEON BLVD STE 2",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320846013",
            "telephone_number": "904-829-6321",
            "fax_number": "904-829-2338"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCLELLAN",
        "first_name": "BARBARA",
        "middle_name": "AGNES",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-30",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN 13672",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Thomas Edward McKenzie, D.O.
• Hailey Wilson McKinley, DDS, MSD
• Joseph Matthew McKinley, M.D.
• Kim McKinney, OT/PT
• McLellan Dental Inc.
• Matthew McLellan, DMD
• Sandra McLeod-Batton, RN
• Robert Michael McMahon, RPH
• Jillian A McManus, PT, DPT
• Breanna Maureen McMillan Conde, MS, LMHC

• General Practice Dentistry in St Augustine, FL
• Providers in St Augustine, FL by specialty
• General Practice Dentistry in Florida

• 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.