Marvin Glen Clothier, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

4664 Issued in KS

Practice address

611 N Broadway
Pittsburg, KS 66762

Phone

(620) 231-4140

Fax

(620) 231-4202

NPI assigned

Oct 7, 2008

Last updated

Oct 7, 2008By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Enrolled in KS

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Marvin G Clothier DDS PA

  • Dentist
  • Pittsburg, KS
  • NPI 1457327405
  NPD (past) Authorized official

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

{
    "created_epoch": "1223337600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1223337600000",
    "number": "1982855193",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "611 N BROADWAY",
            "city": "PITTSBURG",
            "state": "KS",
            "postal_code": "66762",
            "telephone_number": "620-231-4140",
            "fax_number": "620-231-4202"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "611 N BROADWAY",
            "city": "PITTSBURG",
            "state": "KS",
            "postal_code": "66762",
            "telephone_number": "620-231-4140",
            "fax_number": "620-231-4202"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLOTHIER",
        "first_name": "MARVIN",
        "middle_name": "GLEN",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-10-07",
        "last_updated": "2008-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "KS",
            "license": "4664",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Annie Mae Christian, NP
• Debra Mae Clark, PTA
• Lindsey Erin Clark, DDS
• Jennifer Dawn Classen
• Sally Cathleen Clay, LPC
• Kerri L Coble, RPH
• Melissa Coester, PTA
• Vernetta Collins, AAPS COUNSELOR
• Judith A Coltharp, FNP
• Kent A Coltharp, DO

• General Practice Dentistry in Pittsburg, KS
• Providers in Pittsburg, KS by specialty
• General Practice Dentistry in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2008; 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.