Matthew S. Clegg, DDS, Ms, P.S.

Primary specialty

EndodonticsTaxonomy code 1223E0200X

License

DE00010180 Issued in WA

Legal business name

MATTHEW S. CLEGG, DDS, MS, P.S.

Doing business as

Clearwater Endodontics

Practice address

802 7TH St
Clarkston, WA 99403-2022

Phone

(509) 758-4181

Fax

(509) 758-4756

NPI assigned

Jun 18, 2012

Organization subpart

No

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

Authorized official

Name

Matthew S Clegg, D.D.S., M.S.NPI 1336122118

Title

President

Phone

(509) 758-4181

Specialties & licenses 1

Addresses

Other names 1

• Clearwater Endodontics Doing business as

Practitioners 1

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

• Matthew S. Clegg, D.D.S., M.S.

  • Endodontics
  • Clarkston, WA
  • NPI 1336122118
  NPD (past) Authorized official

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

{
    "created_epoch": "1339977600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1339977600000",
    "number": "1750644498",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "802 7TH ST",
            "city": "CLARKSTON",
            "state": "WA",
            "postal_code": "994032022",
            "telephone_number": "509-758-4181",
            "fax_number": "509-758-4756"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "802 7TH ST",
            "city": "CLARKSTON",
            "state": "WA",
            "postal_code": "994032022",
            "telephone_number": "509-758-4181",
            "fax_number": "509-758-4756"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MATTHEW S. CLEGG, DDS, MS, P.S.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-06-18",
        "last_updated": "2012-06-18",
        "status": "A",
        "authorized_official_last_name": "CLEGG",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "509-758-4181",
        "authorized_official_credential": "D.D.S., M.S."
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Endodontics",
            "state": "WA",
            "license": "DE00010180",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Clearwater Endodontics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• David B Martin, M.D.
• Melissa Martinez
• Marie Laurie Al Martson, RN
• Marissa Martz
• Catherine A Massee, BS, CDP
• Racheal McCormack
• Anissa Jean McFarland, RN
• Sandy McIntyre, RC
• Mark C McKarcher, MA, LMHC
• Brenda Annette McLellan

• Endodontics in Clarkston, WA
• Providers in Clarkston, WA by specialty
• Endodontics in Washington

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