Clayton Shane Oliver, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DN015447 Issued in GA

Practice address

421 Plaza Ave
Eastman, GA 31023-6749

Phone

(478) 374-4716

NPI assigned

Jun 21, 2017

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 and National Provider Directory roles.

• Eastman Family Dental Center LLP

  • General Practice Dentistry
  • Eastman, GA
  • NPI 1760706584

  General Practice

  NPD (past)

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

{
    "created_epoch": "1498003200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1498003200000",
    "number": "1801316997",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "198 E PEACOCK ST",
            "city": "COCHRAN",
            "state": "GA",
            "postal_code": "310147852",
            "telephone_number": "478-230-1346"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "421 PLAZA AVE",
            "city": "EASTMAN",
            "state": "GA",
            "postal_code": "310236749",
            "telephone_number": "478-374-4716"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLIVER",
        "first_name": "CLAYTON",
        "middle_name": "SHANE",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-06-21",
        "last_updated": "2017-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "GA",
            "license": "DN015447",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ocmulgee Family Medicine LLC.
• Ocmulgee Internal Medicine and Nephrology, LLC
• Ocmulgee Medical Services, LLC
• Ocmulgee Urology, LLC
• Brande Barlow Ogden, COTA/L
• Tammie Dianne Oliver, FNP
• Amanda Llyn Parkerson, FNP-C
• James L. Parkerson, O.D.
• Patricia Patterson MD LLC
• Catherine Thompson Patrick, NP

• All providers in Eastman, GA
• General Practice Dentistry in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2017; 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.