Active NPI
Duane Cardon Clouse, D.D.S.
- Pediatric Dentistry
- Maricopa, AZ
National Provider Identifier
1861484388
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Dentistry
- License
- 4230
- Practice address
- 21300 N John Wayne Pkwy Ste 117
Maricopa, AZ 85139-8978 - Phone
- (480) 272-3374
- Fax
- (520) 316-6264
- NPI assigned
- Aug 19, 2005
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Dentistry | 1223P0221X | 4230 | AZ | Primary |
Addresses
Primary practice location
21300 N John Wayne Pkwy Ste 117
Maricopa, AZ 85139-8978
Mailing address
21300 N John Wayne Pkwy Ste 117
Maricopa, AZ 85139-8978
Phone (480) 272-3374
Other practice location 1
4025 W Bell Rd
Suite 18
Phoenix, AZ 85053-2750
Phone (602) 843-1275
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 115073 | Medicaid | AZ |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Duance C. Clouse DDS PC | Pediatric Dentistry | Past | Accepting new patients |
| Az Specialty Dental Services, LLC | Pediatric Dentistry | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Pediatric Dentistry
- Maricopa, AZ
- NPI 1861699902
-
- Pediatric Dentistry
- Maricopa, AZ
- NPI 1447090279
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1124409600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1529107200000",
"number": "1861484388",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "21300 N JOHN WAYNE PKWY STE 117",
"city": "MARICOPA",
"state": "AZ",
"postal_code": "851398978",
"telephone_number": "480-272-3374",
"fax_number": "520-316-6264"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "21300 N JOHN WAYNE PKWY STE 117",
"city": "MARICOPA",
"state": "AZ",
"postal_code": "851398978",
"telephone_number": "480-272-3374",
"fax_number": "520-316-6264"
}
],
"practiceLocations": [
{
"address_1": "4025 W Bell Rd",
"address_2": "Suite 18",
"address_purpose": "LOCATION",
"city": "Phoenix",
"state": "AZ",
"postal_code": "850532750",
"country_code": "US",
"telephone_number": "602-843-1275",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "CLOUSE",
"first_name": "DUANE",
"middle_name": "CARDON",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-08-19",
"last_updated": "2018-06-16",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0221X",
"taxonomy_group": "",
"desc": "Dentist, Pediatric Dentistry",
"state": "AZ",
"license": "4230",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "115073",
"state": "AZ"
}
],
"endpoints": [],
"other_names": []
}Other providers in Maricopa, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 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.