Clay Gary Powelson, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

13352 Issued in NC

Practice address

3094 Hickory Blvd
Hudson, NC 28638-2659

Phone

(828) 726-0202

Fax

(828) 728-0300

NPI assigned

Jun 23, 2023

Last updated

Jun 23, 2023By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

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": "1687478400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687478400000",
    "number": "1841976941",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1107",
            "city": "HUDSON",
            "state": "NC",
            "postal_code": "286381107",
            "telephone_number": "828-726-0202",
            "fax_number": "828-728-0300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3094 HICKORY BLVD",
            "city": "HUDSON",
            "state": "NC",
            "postal_code": "286382659",
            "telephone_number": "828-726-0202",
            "fax_number": "828-728-0300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POWELSON",
        "first_name": "CLAY",
        "middle_name": "GARY",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-06-23",
        "last_updated": "2023-06-23",
        "certification_date": "2023-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NC",
            "license": "13352",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NC",
            "license": "13352",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• General Practice Dentistry in Hudson, NC
• Providers in Hudson, NC by specialty
• General Practice Dentistry in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2023; 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.