Corbet Clarke Locke III, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

14656 Issued in TX

Practice address

307 Crossroads West
Waco, TX 76712

Phone

(254) 776-4888

Fax

(254) 776-4668

NPI assigned

Oct 3, 2006

Last updated

Jul 8, 2007By 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

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Mar 30, 2016 through Mar 30, 2028

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1639263353",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "307 CROSSROADS WEST",
            "city": "WACO",
            "state": "TX",
            "postal_code": "76712",
            "telephone_number": "254-776-4888",
            "fax_number": "254-776-4668"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "307 CROSSROADS WEST",
            "city": "WACO",
            "state": "TX",
            "postal_code": "76712",
            "telephone_number": "254-776-4888",
            "fax_number": "254-776-4668"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOCKE",
        "first_name": "CORBET",
        "middle_name": "CLARKE",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "14656",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• William Scott Livesay, DR MD
• Melissa L Lobianco, MS RD LD
• Amy Lynn Lobrano, M.D.
• Abigail Madeline Locke
• Bonnie L Locke, C.O.T.A.
• Kyasue Denae Locke
• Morgan Locke
• Jordyn D Lockhart
• Michael Allen Loden, MD
• Kristy B Lohr, LPC

• General Practice Dentistry in Waco, TX
• Providers in Waco, TX by specialty
• General Practice Dentistry 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.