Charles Forrer Anderson McCluer III, D.D.S.

Primary specialty

DentistTaxonomy code 122300000X

License

12214 Issued in TX

Practice address

3600 Hulen St
BLDG. A1
Fort Worth, TX 76107-6863

Phone

(817) 731-2661

Fax

(817) 731-2665

NPI assigned

Jul 13, 2005

Last updated

Jul 8, 2007By the provider in NPPES

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

Enrolled in TX

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

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1121212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1497753339",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3600 HULEN ST",
            "address_2": "BLDG. A1",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761076863",
            "telephone_number": "817-731-2661",
            "fax_number": "817-731-2665"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3600 HULEN ST",
            "address_2": "BLDG. A1",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761076863",
            "telephone_number": "817-731-2661",
            "fax_number": "817-731-2665"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCLUER",
        "first_name": "CHARLES",
        "middle_name": "FORRER ANDERSON",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TX",
            "license": "12214",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bethany McClean, RN, CFNP
• Susen Deanne McCleery-Derrick, FNP
• Mary Margaret McClelen, DNP, FNP-C
• Jennifer E McCliment, AUD
• Nichole McCloy, RN, IBCLC
• Cooper Lowe McClung I, LPC
• Jamy C. Black McCole, OT
• Shaterra McCollister, CPNP-PC
• Aaryn McComb, O.D.
• Bradley A. McConnell, D.D.S.

• Dentist in Fort Worth, TX
• Providers in Fort Worth, TX by specialty
• Dentist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.