CLARK FAMILY DENTISTRY (NPI# 1053568477) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1053568477 |
| Entity Type | Organization |
| Organization Name | CLARK FAMILY DENTISTRY |
| Other Organization Name | HEATHER E. CLARK |
| Practice Address |
1331 Village Dr Saint Joseph MO 64506-2457 |
| Practice Telephone | 8162321444 |
| Practice Fax Number | 8162791450 |
| Mailing Telephone | 8162321444 |
| Mailing Fax Number | 8162791450 |
| Enumeration Date | 2008-08-27 |
| Last Update Date | 2008-08-27 |
| Authorized Official Name | DR. HEATHER ELISE CLARK (PRESIDENT/DENTIST) |
| Authorized Official Telephone | 8162321444 |
| Authorized Official Credential | DDS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
2007014394 | MO | Dental Providers |
| Other Name | Type Code |
|---|---|
| Heather E. Clark | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548571078 | Clark Family Dentistry | Dentist | 630 Laurel St, Orangeburg, SC 29115-4835 | 2010-06-30 |
| 1871627380 | Clark Family Dentistry | Dentist | 639 Lotus Dr N, Mandeville, LA 70471-2926 | 2007-03-15 |
| 1891896148 | Clark Family Dentistry | Dental Hygienist | 639 Lotus Dr N, Mandeville, LA 70471 | 2006-09-26 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | CLARK FAMILY DENTISTRY | 141 W 20th St, Farmington, NM 87401-3401 |
| Oregon Corporations, Companies and Business Names | CLARK FAMILY DENTISTRY | 2727 Sw 17th Pl, Redmond, OR 97756 |
| Oregon Corporations, Companies and Business Names | CLARK FAMILY DENTISTRY, PC | 2727 Sw 17th Pl, Redmond, OR 97756 |
| Street Address |
1331 VILLAGE DR |
| City | SAINT JOSEPH |
| State | MO |
| Zip Code | 64506-2457 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750320818 | Mary Elaine Greer | Nurse Practitioner | 1331 Village Dr, Saint Joseph, MO 64506-2457 | 2006-06-05 |
| 1710479894 | Ashley Rose Deacy | Dentist | 1331 Village Dr, Saint Joseph, MO 64506-2457 | 2018-06-04 |
| 1609043587 | Heather Elise Clark | Dentist | 1331 Village Dr, Saint Joseph, MO 64506-2457 | 2008-05-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700484250 | Americare At Field Pointe LLC | Assisted Living Facility | 5002 Gene Field Road, St Joseph, MO 64506 | 2020-10-15 |
| 1669086609 | Phuc Vo | Pharmacist | 4022 N Belt Hyw, Saint Joseph, MO 64506 | 2020-09-08 |
| 1104450675 | Hughes Acupuncture LLC | Acupuncturist | 1918 North Belt Highway, St Joseph, MO 64506 | 2020-02-24 |
| 1306323316 | Camilla Allison Walling | Nurse Practitioner | 1009 West St. Maartens Drive Suite F, Saint Joseph, MO 64506 | 2018-07-23 |
| 1326559964 | Amber Wheatley Wood | Counselor | 724 N. 22nd Street, Saint Joseph, MO 64506 | 2017-10-23 |
| 1366952988 | Annette Burris | Audiologist | 2401 North Woodbine, St. Joseph, MO 64506 | 2017-10-10 |
| 1962927665 | Genuine Senior Care LLC | In Home Supportive Care | 3715 Beck Road, Suite 207b, St. Joseph, MO 64506 | 2017-08-03 |
| 1215396569 | Andrew M Fisher | Counselor | 2400 Frederick Blvd, Suite 407, Saint Joseph, MO 64506 | 2016-02-15 |
| 1699133678 | Missouri Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 3320 North Belt Highway, St Joseph, MO 64506 | 2016-02-04 |
| 1598167587 | Quality Hearing and Audiology Center LLC | Audiologist | 2227 North Belt Highway, St. Joseph, MO 64506 | 2014-09-22 |
| Find all providers in zip 64506 | ||||
| Taxonomy Code | 1223G0001X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | General Practice |
| A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. |
| Notes: Source: Academy of General Dentistry |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861878308 | Bradley Scott Williams | Dentist | 5101 N Belt Hwy, Saint Joseph, MO 64506-1261 | 2015-08-06 |
| 1184968695 | Missouri Dental Professionals, Richard Straus, Dmd, PC | Dentist | 4112 N Belt Hwy, Saint Joseph, MO 64506-1281 | 2012-11-21 |
| 1891085676 | Charles Howenstine | Dentist | 3386 Niles Rd, Saint Joseph, MI 49085-8800 | 2011-04-13 |
| 1366620304 | Richard Carl Hake | Dentist | 1626 Langley Ave, Saint Joseph, MI 49085-1733 | 2008-02-01 |
| 1750591665 | Arthur Scott Nelson | Dentist | 2401 Frederick Ave, Saint Joseph, MO 64506-2727 | 2007-05-23 |
| 1376760611 | Lisa Ann Goin | Dentist | 805 N 36th St, Suite A, Saint Joseph, MO 64506-2979 | 2007-04-19 |
| 1578789939 | Robert. L. Brunker, D.d.s., P.C. | Dentist | 103 S 36th St, Saint Joseph, MO 64506-2920 | 2007-04-17 |
| 1558586248 | M Ichael Frank Contardo | Dentist | 26 2nd Ave Nw, Saint Joseph, MN 56374-4106 | 2007-04-16 |
| 1962520833 | George Robert Ruwwe Jr. | Dentist | 710 Felix St, Saint Joseph, MO 64501-2236 | 2007-03-27 |
| 1669597043 | W R Ted Kuball | Dentist | 3012 Niles Rd, Saint Joseph, MI 49085-8653 | 2007-03-21 |
| Find all providers in SAINT JOSEPH | ||||
| City | SAINT JOSEPH |
| Zip Code | 64506 |
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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.