DR. THOMAS JAGGERS CLARK (NPI# 1134236359) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1134236359 |
| Entity Type | Individual |
| Full Name | DR. THOMAS JAGGERS CLARK |
| Credential | DMD |
| Practice Address |
5805 W Highway 22 Crestwood KY 40014-7244 |
| Practice Telephone | 5022417116 |
| Practice Fax Number | 5022412339 |
| Mailing Telephone | 5022417116 |
| Mailing Fax Number | 5022412339 |
| Enumeration Date | 2006-08-24 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| X | 122300000X | Dentist | 4571 | KY | Dental Providers |
| X | 1223G0001X |
Dentist Specialization: General Practice |
4571 | KY | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| KY | 60045713 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669096020 | Thomas Edward Clark | Optometrist | 3672 W South Jordan Pkwy Ste 103, South Jordan, UT 84009-7172 | 2020-06-02 |
| 1861053811 | Thomas J Clark | Massage Therapist | 16615 North Rd Unit B, Bothell, WA 98012-5983 | 2019-06-20 |
| 1922417005 | Thomas Boyle Clark IIi | Pathology | 3619 Pacific Ave, Tacoma, WA 98418-7921 | 2014-08-04 |
| 1053558205 | Thomas Edward Clark | Student in an Organized Health Care Education/Training Program | 980 Western Avenue, Albany, NY 12202 | 2009-01-09 |
| 1255593273 | Thomas James Clark | Licensed Practical Nurse | 8703 Shear Dr, Powell, OH 43065-8835 | 2008-06-30 |
| 1508044181 | Thomas B Clark | Chiropractor | 2092 Casa De Vereda, Vista, CA 92084-4223 | 2008-02-05 |
| 1306061502 | Thomas Lyon Clark | Psychologist | 1515 Payne St, Tallahassee, FL 32303-5796 | 2007-04-16 |
| 1487877213 | Thomas R Clark | Chiropractor | 2418 W 9th Ave, Amarillo, TX 79106-6620 | 2007-04-10 |
| 1023157153 | Thomas Clark | Dentist | 4402 Airline Dr, Houston, TX 77022-2934 | 2007-02-05 |
| 1972649499 | Thomas Colin Clark | Physical Therapist | 7111 E 21st St N Ste 103, Wichita, KS 67206 | 2007-01-30 |
| Street Address |
5805 W HIGHWAY 22 |
| City | CRESTWOOD |
| State | KY |
| Zip Code | 40014-7244 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043229545 | Alan R Gould | Dentist | 5805 W Highway 22, Crestwood, KY 40014-7244 | 2006-08-05 |
| 1942317169 | James Marcus Wenninger | Dentist | 5805 W Highway 22, Crestwood, KY 40014-7244 | 2006-08-24 |
| 1558370031 | Alan R Gould Dds Ms LLC | Dentist | 5805 W Highway 22, Crestwood, KY 40014-7244 | 2006-08-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720411556 | Meagan L Vowels | Behavioral Analyst | 5895 W. Hwy 146, Crestwood, KY 40014 | 2013-08-15 |
| 1003157538 | Craig L Satterley | Physical Therapist | 6003 Pleasant Colony Ct Ste 3, Crestwood, KY 40014 | 2013-03-07 |
| 1871868802 | Wallace Lyle Past Sr. | General Practice | 4608 Heritage Manor, Crestwood, KY 40014 | 2012-03-08 |
| 1609153725 | Patricia Ann Gray | Behavioral Analyst | 5895 W Highway 146, Crestwood, KY 40014 | 2011-11-03 |
| 1528374253 | Laura R Carroll | Dentist | 6344 W. Hwy 146 Ste 100, Crestwood, KY 40014 | 2010-08-18 |
| 1699922849 | Mortenson Family Dental Center | Clinic/Center | 6408 W Hwy 146, Crestwood, KY 40014 | 2008-08-19 |
| 1760658546 | Kathy J. Pansegrau, Dc, Psc | Chiropractor | 6402 Westwind Way, Suite 5, Crestwood, KY 40014 | 2008-05-01 |
| 1952584054 | Alyssa Ann Dykgraaf | Dentist | 5805 Whwy 22, Ste 100, Crestwood, KY 40014 | 2007-12-11 |
| 1780881649 | Gwinn A. K. Vonnahme | Dentist | 5998 Pleasant Colony Ct. Suite 23, Crestwood, KY 40014 | 2007-07-02 |
| 1326250960 | Sue B Feeley | Dentist | 6225 W Hwy 146, Crestwood, KY 40014 | 2007-05-04 |
| Find all providers in zip 40014 | ||||
| Taxonomy Code | 122300000X |
| Grouping | Dental Providers |
| Classification | Dentist |
| A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962958330 | Jihan Doss | Dentist | 13442 Cicero Ave, Crestwood, IL 60418-1430 | 2016-08-26 |
| 1205248499 | Brittany Lynn Holeman | Dentist | 8815 W Highway 22, Crestwood, KY 40014-8011 | 2014-05-22 |
| 1417238858 | John Arce | Dentist | 14154 Cicero Ave, Crestwood, IL 60445-2153 | 2011-08-30 |
| 1528374253 | Laura R Carroll | Dentist | 6344 W. Hwy 146 Ste 100, Crestwood, KY 40014 | 2010-08-18 |
| 1952584054 | Alyssa Ann Dykgraaf | Dentist | 5805 Whwy 22, Ste 100, Crestwood, KY 40014 | 2007-12-11 |
| 1083834790 | David Todd Kamer | Dentist | 5301 W Hwy 146, Crestwood, KY 40014-8596 | 2007-04-26 |
| 1154475630 | Kevin Martin Bargamian | Dentist | 13549 South Cicero Avenue, Crestwood, IL 60445 | 2007-01-22 |
| 1295884450 | Robert W Gentile | Dentist | 4753 W 138th Street, Crestwood, IL 60445 | 2007-01-09 |
| 1174594378 | Michael A. Luckett D.m.d. & Associates (rivercrest), Ltd. | Dentist | 4839 West Calsag Rd, #310, Crestwood, IL 60445-4415 | 2006-01-27 |
| 1891319737 | Amin Elsaeed | Dentist | 13442 Cicero Ave, Crestwood, IL 60418-1430 | 2020-06-06 |
| Find all providers in CRESTWOOD | ||||
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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.