Michael Thomas McClure, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

DN 15444 Issued in FL

Practice address

1409 Kingsley Ave
Suite 7a
Orange Park, FL 32073-4537

Phone

(904) 269-1419

Fax

(904) 269-1307

NPI assigned

Aug 9, 2006

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 FL

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1155081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1475452800000",
    "number": "1790795086",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1409 KINGSLEY AVE",
            "address_2": "SUITE 7A",
            "city": "ORANGE PARK",
            "state": "FL",
            "postal_code": "320734537",
            "telephone_number": "904-269-1419",
            "fax_number": "904-269-1307"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1409 KINGSLEY AVE",
            "address_2": "SUITE 7A",
            "city": "ORANGE PARK",
            "state": "FL",
            "postal_code": "320734537",
            "telephone_number": "904-269-1419",
            "fax_number": "904-269-1307"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCLURE",
        "first_name": "MICHAEL",
        "middle_name": "THOMAS",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-09",
        "last_updated": "2016-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN 15444",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alvin Michael McClain, R.PH.
• Tiffany McClain
• William Shane McClanahan, PA-C
• Michael G. McClendon, LMHC
• Aaron Joseph McClure, D.O.
• Kelly McComiskey, ATC
• Dee Alexandra McConnell, NP
• Erica McConnell
• Lyndsey McCool, L.M.T.
• Pamela McCormick, MA

• Dentist in Orange Park, FL
• Providers in Orange Park, FL by specialty
• Dentist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2016; 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.