Vaughn Clemens, D.D.S

Primary specialty

EndodonticsTaxonomy code 1223E0200X

License

DI020601 Issued in NJ

Practice address

120 S 6TH St
Vineland, NJ 08360-4605

Phone

(856) 692-5533

Fax

(856) 692-4990

NPI assigned

Dec 15, 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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in PA

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": "1134604800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1538145271",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 S 6TH ST",
            "city": "VINELAND",
            "state": "NJ",
            "postal_code": "083604605",
            "telephone_number": "856-692-5533",
            "fax_number": "856-692-4990"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 S 6TH ST",
            "city": "VINELAND",
            "state": "NJ",
            "postal_code": "083604605",
            "telephone_number": "856-692-5533",
            "fax_number": "856-692-4990"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLEMENS",
        "first_name": "VAUGHN",
        "name_prefix": "Dr.",
        "credential": "D.D.S",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-15",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "NJ",
            "license": "DI020601",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID #",
            "identifier": "223674675",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jennifer Anne Clark, N.P.-C
• Susan M Clark, NP
• Claybrooks Medical Transportation
• Claybrooks Transportation
• Galen Germaine Claybrooks
• Lawrence P Clinton, M.D.
• Kayana Clue
• Lauren Susan Coffua, DO, MS
• Susan Elizabeth Cohen, MSN APN
• Steven M Cohn, MD

• Endodontics in Vineland, NJ
• Providers in Vineland, NJ by specialty
• Endodontics in New Jersey

• 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.