NPIMap

Organization Active NPI

William W Clance DMD PC

  • General Practice Dentistry
  • Metter, GA
National Provider Identifier
1407963853
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
9149 Issued in GA
Legal business name
WILLIAM W CLANCE DMD PC
Practice address
500 N Lewis St
Metter, GA 30439
Phone
(912) 685-2100
Fax
(912) 685-6915
NPI assigned
Aug 23, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. William Wesley Clance Jr., DMDNPI 1245379213
Title
Ceo
Phone
(912) 685-2100

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 9149 GA Primary

Addresses

Primary practice location

500 N Lewis St
Metter, GA 30439

Mailing address

PO Box 718
Metter, GA 30439
Phone (912) 685-2100

Other names 1

  • Prof Corp Other name

National Provider Directory

National Provider Directory

Locations

500 N Lewis St
Metter, GA 30439
Phone (912) 685-2100

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1156291200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1407963853",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 718",
            "city": "METTER",
            "state": "GA",
            "postal_code": "30439",
            "telephone_number": "912-685-2100",
            "fax_number": "912-685-6915"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 N LEWIS ST",
            "city": "METTER",
            "state": "GA",
            "postal_code": "30439",
            "telephone_number": "912-685-2100",
            "fax_number": "912-685-6915"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILLIAM W CLANCE DMD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-23",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "CLANCE",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "WESLEY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "912-685-2100",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "GA",
            "license": "9149",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Prof Corp",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Metter, GA

Sources for this page

  • 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.