James Scott Clement
Individual provider Active NPI Dentist · Saint Ignace, MI
NPI 1497284129 · NPPES record last updated Jul 21, 2022
Key facts
- NPI
- 1497284129
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dentist 122300000X
- License
- 2901022245 (MI)
- Practice address
- 314 N State St
Saint Ignace, MI 49781-1425 - Phone
- (906) 643-9245
- NPI assigned
- Jun 6, 2017
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Dec 18, 2019 through Dec 18, 2027
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2901022245 | MI | MD | Dentist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 2901022245 | MI | Yes |
Addresses
Primary practice location
314 N State St
Saint Ignace, MI 49781-1425
Mailing address
314 N State St
Saint Ignace, MI 49781-1425
Phone (906) 643-9245
Other providers in Saint Ignace, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 21, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Opt Out Affidavits (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.