Individual provider Active NPI

Samuel Clark McLemore Jr., DMD

  • General Practice Dentistry
  • Montgomery, AL
National Provider Identifier
1548762834
Registry record updated Oct 6, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
6495 Issued in AL
Practice address
5740 Carmichael Rd
Montgomery, AL 36117-2312
Phone
(334) 277-9570
Fax
(334) 277-0152
NPI assigned
Mar 2, 2018
Last updated
Oct 6, 2021By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 6, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 6495 AL Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

5740 Carmichael Rd
Montgomery, AL 36117-2312

Mailing address

5740 Carmichael Rd
Montgomery, AL 36117-2312
Phone (334) 277-9570

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
6495ALMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
McLemore Dentistry, LLC CurrentSince Oct 10, 2021 Accepting new patients
Mission Dental Mobile LLC Single Specialty PastSince Mar 12, 2024 Accepting new patients
Thomas H. Williams III DMD, PC General Practice PastSince Oct 10, 2021 Accepting new patients

Locations

5740 Carmichael Rd
Montgomery, AL 36117
Phone (334) 277-9570

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1519948800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633478400000",
    "number": "1548762834",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5740 CARMICHAEL RD",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361172312",
            "telephone_number": "334-277-9570",
            "fax_number": "334-277-0152"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5740 CARMICHAEL RD",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361172312",
            "telephone_number": "334-277-9570",
            "fax_number": "334-277-0152"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCLEMORE",
        "first_name": "SAMUEL",
        "middle_name": "CLARK",
        "name_suffix": "Jr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-03-02",
        "last_updated": "2021-10-06",
        "certification_date": "2021-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AL",
            "license": "6495",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Montgomery, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2021; 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.