Marissa Chevaughn Clemente, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

052943-1 Issued in NY

Practice address

603 Route 304
New City, NY 10956-2919

Phone

(845) 638-6646

NPI assigned

Mar 7, 2011

Sex

Female

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

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Clemente Orthodontics of New York PC

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • New City, NY
  • NPI 1932524188
  NPD (past)

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

{
    "created_epoch": "1299456000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1299456000000",
    "number": "1699073247",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "603 ROUTE 304",
            "city": "NEW CITY",
            "state": "NY",
            "postal_code": "109562919",
            "telephone_number": "845-638-6646"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "603 ROUTE 304",
            "city": "NEW CITY",
            "state": "NY",
            "postal_code": "109562919",
            "telephone_number": "845-638-6646"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLEMENTE",
        "first_name": "MARISSA",
        "middle_name": "CHEVAUGHN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-03-07",
        "last_updated": "2011-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "052943-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Clarkstown Pharmacy II LLC
• Clarkstown Physical Therapy & Sports Associates, LLP
• Clarkstown Urology PC
• Diane Cleary, LCSW-R
• Clemente Orthodontics of New York PC
• Michelle Clinton
• Clnivators
• Michael Cocilovo, D.C.
• Dawn Louise Coffey, R.D., CDN
• Alise R Cohen, LCSW

• General Practice Dentistry in New City, NY
• Providers in New City, NY by specialty
• General Practice Dentistry in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2011; 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.