Mary McClellan DMD

Primary specialty

DentistTaxonomy code 122300000X

License

13748 Issued in MO

Legal business name

MARY MCCLELLAN DMD

Practice address

950 Francis PL Ste 310
Saint Louis, MO 63105-2465

Phone

(314) 726-6966

Fax

(314) 726-5194

NPI assigned

May 17, 2007

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Mary McClellan, DMDNPI 1184712135

Title

President

Phone

(314) 726-6966

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Mary McClellan, DMD

  • Dentist
  • Clayton, MO
  • NPI 1184712135
  NPD (past) Authorized official

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

{
    "created_epoch": "1179360000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1932316981",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "950 FRANCIS PL STE 310",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631052465",
            "telephone_number": "314-726-6966",
            "fax_number": "314-726-5194"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "950 FRANCIS PL STE 310",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631052465",
            "telephone_number": "314-726-6966",
            "fax_number": "314-726-5194"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARY MCCLELLAN DMD",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-17",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MCCLELLAN",
        "authorized_official_first_name": "MARY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "314-726-6966",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MO",
            "license": "13748",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LISCENSE",
            "identifier": "13748",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mary Ann Cheng MD LLC
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• Mary J's Home Health Services LLC
• Mary Jane Lane LMFT, LLC (Mary Jane Lane)
• Mary Queen and Mother Association (Mary Queen and Mother Center)
• Mary Ryder Home
• Mary's Covenant Care Services, LLC
• Mary's Love Care Solutions LLC
• Mary's Love-N-Care LLC

• Dentist in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Dentist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.