Individual provider Active NPI

Robert Harris McClary, DDS

  • Dentist
  • Wellington, FL
National Provider Identifier
1457415986
Registry record updated Dec 30, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DN16189 Issued in FL
Practice address
250 Professional Way
Wellington, FL 33414
Phone
(561) 798-1600
Fax
(561) 798-1269
NPI assigned
Dec 20, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 30, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DN16189 FL Primary

Addresses

Primary practice location

250 Professional Way
Wellington, FL 33414

Mailing address

417Nw16Th St 8
Belle Glade, FL 33430-2441
Phone (561) 996-3700

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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

Enrollment IDStateProvider typePAC IDDetails
I20160112002160 FL Order and Referring Only - DentistPractitioner - Dentist 0840592507

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DN16189FLMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Grayhills and Mohip Dentistry Partnership Dentist Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1166572800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1451433600000",
    "number": "1457415986",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "417NW16TH ST 8",
            "city": "BELLE GLADE",
            "state": "FL",
            "postal_code": "334302441",
            "telephone_number": "561-996-3700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 PROFESSIONAL WAY",
            "city": "WELLINGTON",
            "state": "FL",
            "postal_code": "33414",
            "telephone_number": "561-798-1600",
            "fax_number": "561-798-1269"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCLARY",
        "first_name": "ROBERT",
        "middle_name": "HARRIS",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-20",
        "last_updated": "2015-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN16189",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wellington, FL

Sources for this page

Verify at the official NPI Registry.