Mark Eugene McClary, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

5156 Issued in NE

Practice address

1631 Wetzel Ave, BLDG 815, Attn: MCDS-Be
U.S. Army Dental Activity
Fort Carson, CO 80913

Phone

(719) 526-5400

Fax

(719) 526-8572

NPI assigned

Dec 29, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1135814400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1328745600000",
    "number": "1497732622",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1631 WETZEL AVE, BLDG 815, ATTN: MCDS-BE",
            "address_2": "U.S. ARMY DENTAL ACTIVITY",
            "city": "FORT CARSON",
            "state": "CO",
            "postal_code": "80913",
            "telephone_number": "719-526-5400",
            "fax_number": "719-526-8572"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1631 WETZEL AVE, BLDG 815, ATTN: MCDS-BE",
            "address_2": "U.S. ARMY DENTAL ACTIVITY",
            "city": "FORT CARSON",
            "state": "CO",
            "postal_code": "80913",
            "telephone_number": "719-526-5400",
            "fax_number": "719-526-8572"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCLARY",
        "first_name": "MARK",
        "middle_name": "EUGENE",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-29",
        "last_updated": "2012-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CO",
            "license": "106281",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NE",
            "license": "5156",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jaclyn Mazza, OTR/L
• Erica Mazzaferri
• Timothy James McArthur, PT, DPT, ATC, OCS
• Todd J McArthur, M.D.
• John Thomas McBride, M.D.
• Brittany Lynn McClay, RDN, CSSD
• Emily McDermott, MD
• Ethan Andrew McDonald, PA-C
• Rayanna Lynn McDonald
• Catherine Sue McDowall, MSPT

• General Practice Dentistry in Fort Carson, CO
• Providers in Fort Carson, CO by specialty
• General Practice Dentistry in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 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.