Casey Dean Clingan, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D10895 Issued in OR

Practice address

21300 Highway 62
Shady Cove, OR 97539-7707

Phone

(541) 423-7584

NPI assigned

Aug 21, 2018

Last updated

Aug 21, 2018By the provider in NPPES

Sex

Male

Sole proprietor

No

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

• Gold Hill Family Dentistry, LLC

  • General Practice Dentistry
  • Gold Hill, OR
  • NPI 1760017263
  NPD (past)
• Shady Cove Family Dentistry

  • General Practice Dentistry
  • Shady Cove, OR
  • NPI 1376819656
  NPD (past)

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

{
    "created_epoch": "1534809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1534809600000",
    "number": "1750861431",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "711 NOBILITY DR",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975014482",
            "telephone_number": "870-557-2783"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21300 HIGHWAY 62",
            "city": "SHADY COVE",
            "state": "OR",
            "postal_code": "975397707",
            "telephone_number": "541-423-7584"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLINGAN",
        "first_name": "CASEY",
        "middle_name": "DEAN",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-08-21",
        "last_updated": "2018-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OR",
            "license": "D10895",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mary J. Baker, FNP
• Robert Russell Bennett, D.C.
• Philip Broesamle
• Central Drug Store Inc (Shady Cove Pharmacy)
• Paige Chick
• Eleanor Crescenzi
• Orlinda Mae Delk, BA
• Kristin Carol Diasio, MS SPECIAL EDUCATION
• Direct Physical Therapy, LLC
• Valerie June Dubois, LCSW

• General Practice Dentistry in Shady Cove, OR
• Providers in Shady Cove, OR by specialty
• General Practice Dentistry in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2018; 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.