Brent S McClenny, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

3954 Issued in AL

Practice address

310 W Losey St
Scott Air Force Base, IL 62225-5250

Phone

(618) 256-3322

NPI assigned

Sep 20, 2005

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1127174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1342224000000",
    "number": "1477548014",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "626 QUAIL RUN",
            "city": "O FALLON",
            "state": "IL",
            "postal_code": "622693142",
            "telephone_number": "618-207-9694"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "310 W LOSEY ST",
            "city": "SCOTT AIR FORCE BASE",
            "state": "IL",
            "postal_code": "622255250",
            "telephone_number": "618-256-3322"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCLENNY",
        "first_name": "BRENT",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-20",
        "last_updated": "2012-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AL",
            "license": "3954",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christine Leigh Kmiecik
• Joseph Charles Leondike, DNP, APRN, PMHNP-BC
• Raymund G Lucero, PHYSICAL THERAPIST
• Madison L Marvel, MD
• Asia A Matthews, PA
• Abby McElroy, WHNP
• Michelle McPherson, P.T.
• Taylor Marie Meyers, M.D.
• Daniel Kurt Moffett
• Taylor M O'Neil, MD

• General Practice Dentistry in Scott Air Force Base, IL
• Providers in Scott Air Force Base, IL by specialty
• General Practice Dentistry in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2012; 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.