Clyde Wilson Butler II, D.M.D.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

3153 Issued in AL

Practice address

43200 US Highway 72
Stevenson, AL 35772-6702

Phone

(256) 437-2158

Fax

(256) 437-2230

NPI assigned

Mar 5, 2007

Last updated

Jul 8, 2007By the provider in NPPES

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

Enrolled in AL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Dr. Clyde Butler, LLC

  • Dentist
  • Stevenson, AL
  • NPI 1043484686
  NPD (past) Authorized official
• Stevenson Smiles

  • Dental Clinic/Center
  • Stevenson, AL
  • NPI 1275339608
  NPD (past)

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

{
    "created_epoch": "1173052800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1730218645",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "43200 US HIGHWAY 72",
            "city": "STEVENSON",
            "state": "AL",
            "postal_code": "357726702",
            "telephone_number": "256-437-2158",
            "fax_number": "256-437-2230"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "43200 US HIGHWAY 72",
            "city": "STEVENSON",
            "state": "AL",
            "postal_code": "357726702",
            "telephone_number": "256-437-2158",
            "fax_number": "256-437-2230"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUTLER",
        "first_name": "CLYDE",
        "middle_name": "WILSON",
        "name_prefix": "Dr.",
        "name_suffix": "II",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AL",
            "license": "3153",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alabama Dental Professionals PC (Bigelow Family Dentistry-Stevenson)
• Belinda P Ballard, RPH
• BHG LXX, LLC (BHG Stevenson Treatment Center)
• BHG Lxxii, LLC (BHG Medical Services - Stevenson)
• Bridgeport Family Practice OBGYN Clinic (Mohan & Mohan Medical - West)
• Ronald Edwin Calhoun, M.D.
• Dexter Armond Carter
• Carters Care
• Sarika Popatbhai Desai
• Dr. Clyde Butler, LLC

• General Practice Dentistry in Stevenson, AL
• Providers in Stevenson, AL by specialty
• General Practice Dentistry in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.