David Cary McClenahan, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

19018102 Issued in IL

Practice address

755 South Milwaukee Avenue
Suite 120
Libertyville, IL 60048-3267

Phone

(847) 362-6650

Fax

(847) 362-7902

NPI assigned

Aug 18, 2006

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

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.

Opted out of Medicare

Previously, effective Sep 15, 2014 through Sep 15, 2026

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1155859200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1952415903",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "755 SOUTH MILWAUKEE AVENUE",
            "address_2": "SUITE 120",
            "city": "LIBERTYVILLE",
            "state": "IL",
            "postal_code": "600483267",
            "telephone_number": "847-362-6650",
            "fax_number": "847-362-7902"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "755 SOUTH MILWAUKEE AVENUE",
            "address_2": "SUITE 120",
            "city": "LIBERTYVILLE",
            "state": "IL",
            "postal_code": "600483267",
            "telephone_number": "847-362-6650",
            "fax_number": "847-362-7902"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCLENAHAN",
        "first_name": "DAVID",
        "middle_name": "CARY",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-18",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": "19018102",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Robin Abraham Mathew, APN
• Lisa G. Matthews, RD, LDN
• Meghan Matthews
• Christine Mayworm, DTH, PSYCHOLOGY
• Andrew Mazulis, M.D.
• John McDonald, PA
• Jan McDonnell, M.A.
• Rachel Hammel McDowell, MD
• Karson Elisabeth McEwen
• Katie McFadden, CCC-SLP

• Dentist in Libertyville, IL
• Providers in Libertyville, IL by specialty
• Dentist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.