Betty Derrick Klement, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DN10244 Issued in FL

Practice address

2140 Kingsley Ave
Suite 4
Orange Park, FL 32073-5180

Phone

(904) 272-7277

NPI assigned

Aug 20, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1156032000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1356456651",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2140 KINGSLEY AVE",
            "address_2": "SUITE 4",
            "city": "ORANGE PARK",
            "state": "FL",
            "postal_code": "320735180",
            "telephone_number": "904-272-7277"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2140 KINGSLEY AVE",
            "address_2": "SUITE 4",
            "city": "ORANGE PARK",
            "state": "FL",
            "postal_code": "320735180",
            "telephone_number": "904-272-7277"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLEMENT",
        "first_name": "BETTY",
        "middle_name": "DERRICK",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN10244",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "GA",
            "license": "DN009328",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Paula A Kircher, LCSW
• Leigh Kirchner, M.A.,CCC-SLP
• Carrie A Kissinger, LMT
• Sarah Watson Kitchen
• Mary Catherine Kivett
• Susan V Klima, A.R.N.P.
• Linda Sue Knapp, HAS
• Michael Brian Knapp, HAS, BC-HIS, ACA
• Kaden Joseph Chaix Knecht, MD
• Garfield S Knight, PTA

• General Practice Dentistry in Orange Park, FL
• Providers in Orange Park, 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.