Embrace Clear Lake LLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

EMBRACE CLEAR LAKE LLC

Practice address

210 3Rd Ave South
Clear Lake, SD 57226

Phone

(605) 874-2230

Fax

(605) 657-0054

NPI assigned

Dec 21, 2023

Organization subpart

No

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

Authorized official

Name

Brian Prouty, DDS

Title

Owner

Phone

(605) 874-2230

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1703116800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1703116800000",
    "number": "1639948482",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 3RD AVE SOUTH",
            "city": "CLEAR LAKE",
            "state": "SD",
            "postal_code": "57226",
            "telephone_number": "605-874-2230",
            "fax_number": "605-657-0054"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 3RD AVE SOUTH",
            "city": "CLEAR LAKE",
            "state": "SD",
            "postal_code": "57226",
            "telephone_number": "605-874-2230",
            "fax_number": "605-657-0054"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EMBRACE CLEAR LAKE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-12-21",
        "last_updated": "2023-12-21",
        "certification_date": "2023-12-20",
        "status": "A",
        "authorized_official_last_name": "PROUTY",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "605-874-2230",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• General Practice Dentistry in Clear Lake, SD
• Providers in Clear Lake, SD by specialty
• General Practice Dentistry in South Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2023; 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.