Nathan Freeman Clem, D.M.D.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DD3500 Issued in NM

Practice address

384 Larkfield Rd
East Northport, NY 11731-3527

Phone

(316) 993-4493

NPI assigned

Jun 15, 2011

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in NM

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

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.

• Blue Sky Sleep Solutions

  • General Practice Dentistry
  • Albuquerque, NM
  • NPI 1790432839
  NPD (past)

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

{
    "created_epoch": "1308096000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652054400000",
    "number": "1922393156",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "384 LARKFIELD RD",
            "city": "EAST NORTHPORT",
            "state": "NY",
            "postal_code": "117313527",
            "telephone_number": "631-993-4493"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "384 LARKFIELD RD",
            "city": "EAST NORTHPORT",
            "state": "NY",
            "postal_code": "117313527",
            "telephone_number": "316-993-4493"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLEM",
        "first_name": "NATHAN",
        "middle_name": "FREEMAN",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-06-15",
        "last_updated": "2022-05-09",
        "certification_date": "2022-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "061603",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NM",
            "license": "DD3500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "frontdesk@mascolodental.com",
            "affiliation": "N",
            "address_1": "384 Larkfield Rd",
            "city": "East Northport",
            "state": "NY",
            "country_code": "US",
            "postal_code": "117313527",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Kevin Chung, RPH
• Susan Heather Cianci, MS.CCC.LSP
• Elizabeth Amber Cianciotti
• Steven Donald Ciliotta, DPT
• Anthony Joseph Citrano
• Stephanie Colace, LMHC, NCC, CRC
• Ernest C Collier III, ATC
• Commack Public Schools
• Regine Emmanuela Compere, LPN
• Joseph Conlon, LCSW

• General Practice Dentistry in East Northport, NY
• Providers in East Northport, NY by specialty
• General Practice Dentistry in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2022; 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.