John William Clancy, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Practice address

22 N Park Blvd
Glen Ellyn, IL 60137-5770

Phone

(630) 858-3321

NPI assigned

Jan 2, 2007

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

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

{
    "created_epoch": "1167696000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1821155920",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22 N PARK BLVD",
            "city": "GLEN ELLYN",
            "state": "IL",
            "postal_code": "601375770",
            "telephone_number": "630-858-3321"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22 N PARK BLVD",
            "city": "GLEN ELLYN",
            "state": "IL",
            "postal_code": "601375770",
            "telephone_number": "630-858-3321"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLANCY",
        "first_name": "JOHN",
        "middle_name": "WILLIAM",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-02",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Susan Y. Christopherson, AU.D.
• Dianna Christina Ciardullo, RPH
• Lisa Ciosek, OT
• Elizabeth Cipriano, MS, LCPC, NCC
• Citrine and Indigo Counseling and Wellness PLLC
• Concetta M Clark, M.A.
• Elli Banes Clark, LPC
• Kenneth John Clark
• Jaclynn R Clasen, MD
• Angela Cleary, LCPC

• General Practice Dentistry in Glen Ellyn, IL
• Providers in Glen Ellyn, IL by specialty
• General Practice Dentistry in Illinois

• 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.