Calvin McLemore III, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

54738 Issued in CA

Practice address

362 E Vanderbilt Way
San Bernardino, CA 92408-3593

Phone

(909) 384-1111

NPI assigned

May 17, 2007

Last updated

Apr 24, 2018By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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 CA

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

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

{
    "created_epoch": "1179360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1524528000000",
    "number": "1609083989",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5811",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925175811",
            "telephone_number": "909-733-9491"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "362 E VANDERBILT WAY",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924083593",
            "telephone_number": "909-384-1111"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "17482 Irvine Blvd",
            "address_purpose": "LOCATION",
            "city": "Tustin",
            "state": "CA",
            "postal_code": "927803032",
            "country_code": "US",
            "telephone_number": "909-733-9491",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCLEMORE",
        "first_name": "CALVIN",
        "name_suffix": "III",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-17",
        "last_updated": "2018-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "54738",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Savannah McKay
• Taylor McKelphin Moore, PSYD
• Theresa Marie McKinley, LCSW
• Creshenda McLaughlin
• Sharhonda D McLaurin
• Gabriel Marvin McLeod
• Jasmine Joy McLeod, M.D.
• Kerry M McLoughlin
• Dominique Megan McMahon, AMFT
• Ameerah Rasheedah-Bonner McMann, LMFT

• General Practice Dentistry in San Bernardino, CA
• Providers in San Bernardino, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2018; 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.