Active NPI
Sonia Elisabeth Clesner, D.D.S.
- Dentist
- Mount Airy, MD
National Provider Identifier
1982849824
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 8011
- Practice address
- 4644 Ridge Rd
Mount Airy, MD 21771-8901 - Phone
- (410) 875-2323
- Fax
- (410) 875-2323
- NPI assigned
- Dec 6, 2008
- Last updated
- Apr 17, 2013
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 8011 | MD | Primary |
| Dentist | 122300000X | 4060 | DC | |
| Dentist | 122300000X | 0401008554 | VA |
Addresses
Primary practice location
4644 Ridge Rd
Mount Airy, MD 21771-8901
Mailing address
4644 Ridge Rd
Mount Airy, MD 21771-8901
Phone (410) 875-2323
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MD
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20231222000953 | MD | Order and Referring Only - Dentist | 8123348620 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4060 | DC | MD | Dentist |
| 8011 | MD | MD | Dentist |
| 0401008554 | VA | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| FDC-DDS PC | Dentist | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1228521600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1366156800000",
"number": "1982849824",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4644 RIDGE RD",
"city": "MOUNT AIRY",
"state": "MD",
"postal_code": "217718901",
"telephone_number": "410-875-2323",
"fax_number": "410-875-2323"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4644 RIDGE RD",
"city": "MOUNT AIRY",
"state": "MD",
"postal_code": "217718901",
"telephone_number": "410-875-2323",
"fax_number": "410-875-2323"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CLESNER",
"first_name": "SONIA",
"middle_name": "ELISABETH",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-12-06",
"last_updated": "2013-04-17",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "MD",
"license": "8011",
"primary": true
},
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "DC",
"license": "4060",
"primary": false
},
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "VA",
"license": "0401008554",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mount Airy, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2013; 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.