Individual provider Active NPI

Clark Eugene Cressman, D.D.S.

  • General Practice Dentistry
  • Tullahoma, TN
National Provider Identifier
1457524175
Registry record updated Dec 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
11884 Issued in TN
Practice address
1513 N Jackson St
Tullahoma, TN 37388-2343
Phone
(931) 588-3199
NPI assigned
Apr 3, 2008
Last updated
Dec 11, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 11, 2025

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

Specialties & licenses 8

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 44301 CA
Dentist 122300000X 4938T NV
Dentist 122300000X D5620 AZ
General Practice Dentistry 1223G0001X 4938 NV
General Practice Dentistry 1223G0001X 38682 TX
General Practice Dentistry 1223G0001X 019034706 IL
Dentist 122300000X 4938 NV
General Practice Dentistry 1223G0001X 11884 TN Primary

Addresses

Primary practice location

1513 N Jackson St
Tullahoma, TN 37388-2343

Mailing address

1513 N Jackson St
Tullahoma, TN 37388-2343
Phone (931) 588-3199

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV
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
I20150818006271 NV Order and Referring Only - DentistPractitioner - Dentist 0840505921

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4938NVMDMarriage & Family Therapist
D5620AZMDDentist
44301CAMDDentist
4938TNVMDDentist
019034706ILMDGeneral Practice Dentistry
38682TXMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Ab Dental LLC General Practice PastSince Dec 14, 2025 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1207180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765411200000",
    "number": "1457524175",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1513 N JACKSON ST",
            "city": "TULLAHOMA",
            "state": "TN",
            "postal_code": "373882343",
            "telephone_number": "931-588-3199"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1513 N JACKSON ST",
            "city": "TULLAHOMA",
            "state": "TN",
            "postal_code": "373882343",
            "telephone_number": "931-588-3199"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRESSMAN",
        "first_name": "CLARK",
        "middle_name": "EUGENE",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-04-03",
        "last_updated": "2025-12-11",
        "certification_date": "2025-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "44301",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NV",
            "license": "4938T",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "AZ",
            "license": "D5620",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NV",
            "license": "4938",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "38682",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019034706",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NV",
            "license": "4938",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TN",
            "license": "11884",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tullahoma, TN

Sources for this page

Verify at the official NPI Registry.