Clute Youth Dentistry, Inc.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

12010603A Issued in IN

Legal business name

CLUTE YOUTH DENTISTRY, INC.

Practice address

7524 S Anthony Blvd
Fort Wayne, IN 46816-2523

Phone

(260) 441-8500

Fax

(260) 441-0887

NPI assigned

Jun 30, 2014

Organization subpart

No

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

Authorized official

Name

Dr. Steven Richard Clute, DDSNPI 1063461796

Title

President

Phone

(260) 625-4870

Specialties & licenses 1

Addresses

Other names 1

• SmileWorks Youth Dentistry Doing business as

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Steven Richard Clute, DDS

  • General Practice Dentistry
  • Fort Wayne, IN
  • NPI 1063461796
  NPD (past) Authorized official
• Jennifer Lynn Taylor, DDS

  • General Practice Dentistry
  • Fort Wayne, IN
  • NPI 1124117718
  NPD (past)

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

{
    "created_epoch": "1404086400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1405641600000",
    "number": "1679988588",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7524 S ANTHONY BLVD",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468162523",
            "telephone_number": "260-441-8500",
            "fax_number": "260-441-0887"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7524 S ANTHONY BLVD",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468162523",
            "telephone_number": "260-441-8500",
            "fax_number": "260-441-0887"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLUTE YOUTH DENTISTRY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-06-30",
        "last_updated": "2014-07-18",
        "status": "A",
        "authorized_official_last_name": "CLUTE",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_middle_name": "RICHARD",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "260-625-4870",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "IN",
            "license": "12010603A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SmileWorks Youth Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Shylisha Clopton
• Taneka Clopton, RBT
• Jonathon Closson
• Patricia Clouse, PT
• Stephanie Ann Clouse, NP-C
• Steven Richard Clute, DDS
• CM Heart2Soul, LLC
• CML Healthcare Consultants LLC
• Charles L Coats, MD
• Glenn Stephen Coats, M.D.

• General Practice Dentistry in Fort Wayne, IN
• Providers in Fort Wayne, IN by specialty
• General Practice Dentistry in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2014; 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.