Individual provider Active NPI

Clyde G Steed Jr., DDS

  • General Practice Dentistry
  • Cumming, GA
National Provider Identifier
1679793236
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
8550 Issued in GA
Practice address
2350 Atlanta Hwy
Suite 100
Cumming, GA 30040-8026
Phone
(770) 781-9201
Fax
(678) 513-6373
NPI assigned
Apr 26, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 8550 GA Primary

Addresses

Primary practice location

2350 Atlanta Hwy
Suite 100
Cumming, GA 30040-8026

Mailing address

2350 Atlanta Hwy
Suite 100
Cumming, GA 30040-8026
Phone (770) 781-9201

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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

Enrollment IDStateProvider typePAC IDDetails
I20160617000961 GA Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 6608167879

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
8550GAMDContractor

NPI Registry JSON

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

{
    "created_epoch": "1177545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1679793236",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2350 ATLANTA HWY",
            "address_2": "SUITE 100",
            "city": "CUMMING",
            "state": "GA",
            "postal_code": "300408026",
            "telephone_number": "770-781-9201",
            "fax_number": "678-513-6373"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2350 ATLANTA HWY",
            "address_2": "SUITE 100",
            "city": "CUMMING",
            "state": "GA",
            "postal_code": "300408026",
            "telephone_number": "770-781-9201",
            "fax_number": "678-513-6373"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEED",
        "first_name": "CLYDE",
        "middle_name": "G",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "GA",
            "license": "8550",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cumming, GA

Sources for this page

Verify at the official NPI Registry.