Lane Gibson Clower, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

2535 Issued in MS

Practice address

1202 Hwy 22
Edwards, MS 39066

Phone

(601) 852-2832

Fax

(601) 852-8927

NPI assigned

Nov 24, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

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 MS

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

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Edwards Dental Clinic Inc

  • General Practice Dentistry
  • Edwards, MS
  • NPI 1982740809
  NPD (past) Authorized official

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

{
    "created_epoch": "1164326400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1386710127",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1202 HWY 22",
            "city": "EDWARDS",
            "state": "MS",
            "postal_code": "39066",
            "telephone_number": "601-852-2832",
            "fax_number": "601-852-8927"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1202 HWY 22",
            "city": "EDWARDS",
            "state": "MS",
            "postal_code": "39066",
            "telephone_number": "601-852-2832",
            "fax_number": "601-852-8927"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLOWER",
        "first_name": "LANE",
        "middle_name": "GIBSON",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-24",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MS",
            "license": "2535",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "05730275",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tina Ashley Banks
• Tiara Carroll-Brown, FNP
• Central Mississippi Civic Improvement Association, Inc. (Jackson-Hinds Comprehensive Health Center Edwards Site)
• Divine Healthcare LLC
• Edwards Dental Clinic Inc
• Foster Legacy Care Services Ms, LLC
• Stacey Foster
• Golden Miles Home Services Inc.

• General Practice Dentistry in Edwards, MS
• Providers in Edwards, MS by specialty
• General Practice Dentistry in Mississippi

• 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.