DR. CLARK MACKELPRANG (NPI# 1235486507) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1235486507 |
| Entity Type | Individual |
| Full Name | DR. CLARK MACKELPRANG |
| Credential | DDS, MS |
| Practice Address |
2330 N Rosemont Blvd Unit A Tucson AZ 85712-2159 |
| Practice Telephone | 5203270263 |
| Practice Fax Number | 5203270965 |
| Mailing Telephone | 5203270263 |
| Mailing Fax Number | 5203270965 |
| Enumeration Date | 2012-08-06 |
| Last Update Date | 2019-09-09 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223P0300X |
Dentist Specialization: Periodontics |
D009229 | AZ | Dental Providers |
| Street Address |
2330 N ROSEMONT BLVD UNIT A |
| City | TUCSON |
| State | AZ |
| Zip Code | 85712-2159 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871104950 | Nancy Rae Klug | Registered Nurse | 2380 N Ferguson Ave., Tucson, AZ 85712 | 2020-08-12 |
| 1013525534 | James Tutu Fiske I | Nurse Practitioner | 5700 E. Pima Street Suite C., Tucson, AZ 85712 | 2020-07-21 |
| 1063031953 | Mehera Tiffanie Hormuz | Student in an Organized Health Care Education/Training Program | 5301 E. Grant Rd., Tucson, AZ 85712 | 2020-04-10 |
| 1770133282 | Elizabeth Nadeschzda Lowell | Nurse Practitioner | 4881 E Grant Road, Suite 101, Tucson, AZ 85712 | 2019-09-17 |
| 1174185649 | Pisa Asc Holdco LLC | Clinic/Center | 4741 E Camp Lowell Drive, Tucson, AZ 85712 | 2019-07-03 |
| 1548821838 | Painted Sky Healthcare, Inc. | Hospice Care, Community Based | 2980 N Swan Rd Ste 222, Tucson, AZ 85712 | 2019-06-26 |
| 1558925644 | Helen Jane Lyall | Registered Nurse | Tucson Medical Centre, 5301 E Grant Road, Tucson, AZ 85712 | 2019-04-24 |
| 1760953541 | Anna Marissa Ramirez | Nurse Practitioner | 5170 E Glenn St Ste 160, Tucson, AZ 85712 | 2018-12-05 |
| 1407343841 | Imran Ata Md Pllc | Internal Medicine | 3925 E Fort Lowell Rd Ste 105, Tucson, AZ 85712 | 2018-04-20 |
| 1003322926 | Millennium Acupuncture | Acupuncturist | 6161 E Pima St Tucson Az 85712, Apt 2074, Tucson, AZ 85712 | 2017-12-15 |
| Find all providers in zip 85712 | ||||
| Taxonomy Code | 1223P0300X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Periodontics |
| That specialty of dentistry which encompasses the prevention, diagnosis and treatment of diseases of the supporting and surrounding tissues of the teeth or their substitutes and the maintenance of the health, function and esthetics of these structures and tissues. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962570630 | Brien V. Harvey, Dds, Ms | Dentist | 899 N Wilmot Rd Ste E2, Tucson, AZ 85711-1713 | 2006-12-01 |
| 1417055294 | Southern Arizona Periodontics Plc | Dentist | 5225 E Knight Dr, Ste #401, Tucson, AZ 85712 | 2006-09-20 |
| 1336184415 | Andrew E. Deeb | Dentist | 4008 E Pima St, Tucson, AZ 85712-3317 | 2006-06-20 |
| 1790720886 | George Eli Deeb | Dentist | 5533 E Helen St, Tucson, AZ 85712-4943 | 2006-06-20 |
| 1578550182 | Krystal J. Miles | Dentist | 7225 N Oracle Rd, Ste 201, Tucson, AZ 85704-6322 | 2005-09-29 |
| 1780679878 | Edward Daniel Gall IIi | Dentist | 2330 N Rosemont Blvd, Suite A, Tucson, AZ 85712-2163 | 2005-09-14 |
| 1497755102 | Graig D Brown | Dentist | 3148 N Swan Rd, Tucson, AZ 85712-1227 | 2005-07-22 |
| 1225455637 | Lisa A. Lear, Dds, Msd, PC | Dentist | 6367 E Tanque Verde Rd, Suite 210, Tucson, AZ 85715-3829 | 2014-03-24 |
| 1366726234 | Jared D Roberts | Dentist | 1751 W Orange Grove Rd, Suite 101, Tucson, AZ 85704-1192 | 2011-10-10 |
| 1518259845 | Brien V Harvey | Dentist | 899 N Wilmot Rd, E-2, Tucson, AZ 85711-1714 | 2011-05-04 |
| Find all providers in TUCSON | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.