Sarah Lee Clegg, D.D.S

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D1027 Issued in GU

Practice address

548 S Marine Corps Dr
Tamuning, GU 96913-3539

Phone

(671) 646-5825

NPI assigned

Jun 7, 2014

Last updated

Nov 13, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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.

• Lumina LLC

  dba Mangilao Dental Clinic

  • Dental Clinic/Center
  • Mangilao, GU
  • NPI 1003418369
  NPD (past) Authorized official

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

{
    "created_epoch": "1402099200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605225600000",
    "number": "1457764417",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9868",
            "city": "TAMUNING",
            "state": "GU",
            "postal_code": "969315868",
            "telephone_number": "510-283-3460"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "548 S MARINE CORPS DR",
            "city": "TAMUNING",
            "state": "GU",
            "postal_code": "969133539",
            "telephone_number": "671-646-5825"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1580 Mann Dr",
            "address_purpose": "LOCATION",
            "city": "Pinole",
            "state": "CA",
            "postal_code": "945642523",
            "country_code": "US",
            "telephone_number": "510-724-5330",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "692 N Marine Corps Dr",
            "address_purpose": "LOCATION",
            "city": "Tamuning",
            "state": "GU",
            "postal_code": "969134454",
            "country_code": "US",
            "telephone_number": "671-300-3221",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CLEGG",
        "first_name": "SARAH",
        "middle_name": "LEE",
        "name_prefix": "Dr.",
        "credential": "D.D.S",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-06-07",
        "last_updated": "2020-11-13",
        "certification_date": "2020-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "29923",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "63621",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MP",
            "license": "0134",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "GU",
            "license": "D1027",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jim Nan Chen, M.D.
• Ramsey Neal Chichakli, M.D.
• Alison Chong, FNP
• Dae-Eil Chong
• James Grant Christian, O.D.
• Phyllis Eileen Collins, C.N.P.
• Angela J.P. Cooey, PA-C
• Mariana L.G. Cook-Huynh, MD
• James Philip Cooper-Nurse, PHD, LMHC
• Kathryn May Cooper

• General Practice Dentistry in Tamuning, GU
• Providers in Tamuning, GU by specialty
• General Practice Dentistry in Guam

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 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.