Clarke Stewart Strange

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

3660-12 Issued in MS

Practice address

4500 I 55 N
Highland Village Suite 235
Jackson, MS 39211-5930

Phone

(601) 987-8722

NPI assigned

Jun 28, 2012

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

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Mississippi Dental Center of Jackson LLC

  • General Practice Dentistry
  • Jackson, MS
  • NPI 1811620214

  General Practice

  NPD Authorized official

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

{
    "created_epoch": "1340841600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1340841600000",
    "number": "1710241344",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4500 I 55 N",
            "address_2": "HIGHLAND VILLAGE SUITE 235",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392115930"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4500 I 55 N",
            "address_2": "HIGHLAND VILLAGE SUITE 235",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392115930",
            "telephone_number": "601-987-8722"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STRANGE",
        "first_name": "CLARKE",
        "middle_name": "STEWART",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-06-28",
        "last_updated": "2012-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MS",
            "license": "3660-12",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Marshall James Stout, M.D.
• Michael Tyler Stout, M.D.
• Josephine H. Stouter, PH.D.
• Mary Stover, PT
• Lynn U. Strain, RPH
• Jeffrey Dale Stratton II, M.S.
• Selly Rae Strauch, M.D.
• Ross Elliott Straughan
• Rose Straughter, DMD
• Talya Straughter, LPC

• All providers in Jackson, MS
• General Practice Dentistry in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2012; 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.