H. CLARK III (NPI# 1164800801) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1164800801 |
| Entity Type | Individual |
| Full Name | H. CLARK III |
| Practice Address |
2101 Hill Ave Superior WI 54880-5260 |
| Practice Telephone | 7153925161 |
| Practice Fax Number | 7153927474 |
| Mailing Telephone | 7153925161 |
| Mailing Fax Number | 7153927474 |
| Enumeration Date | 2015-05-14 |
| Last Update Date | 2015-05-14 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 122300000X | Dentist | 5751-15 | WI | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | DENTAL | 12 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386810521 | H. Douglas Clark Jr. | Dentist | 2101 Hill Ave, Superior, WI 54880-5260 | 2008-05-07 |
| 1932198694 | H. Daniel Clark | Dentist | 3000 Stansberry Ln, Suite 101, Franklin, TN 37069 | 2005-10-17 |
| Street Address |
2101 HILL AVE |
| City | SUPERIOR |
| State | WI |
| Zip Code | 54880-5260 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386810521 | H. Douglas Clark Jr. | Dentist | 2101 Hill Ave, Superior, WI 54880-5260 | 2008-05-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104427194 | Alana Catherine Sullivan | Speech-Language Pathologist | 25 N 25th Street E, Superior, WI 54880 | 2020-11-05 |
| 1710524970 | Sean Wiberg Peterson | Specialist/Technologist | 1810 Catlin Ave, Room 1246, Superior, WI 54880 | 2019-12-06 |
| 1558858936 | Brent Adam Engstrom | Student in an Organized Health Care Education/Training Program | 1410 Nth 23rd Street, Superior, WI 54880 | 2018-04-20 |
| 1558769125 | David Kroll | Specialist | Balknap & Catlin Aves., Superior, WI 54880 | 2014-12-15 |
| 1154670321 | Superior Treatment Center, Inc | Community/Behavioral Health | 1507 Tower Ave Ste 307, Superior, WI 54880 | 2012-09-04 |
| 1548551658 | Dionne Jeannine Corcoran | Midwife | 916 Hammond Ave Ste 222, Superior, WI 54880 | 2011-04-22 |
| 1821235433 | Lauren Ashley Miller | Speech-Language Pathologist | 35 N. 28th Street, Superior, WI 54880 | 2009-01-20 |
| 1528261989 | Stacy Ann Kennelly | Physical Therapist | 1612 N 37th Street, Superior, WI 54880 | 2007-06-06 |
| 1760564942 | James Henry Dobis | Family Medicine | 3520 Tower Avenue, Twin Ports Va Outpatient Clinic, Superior, WI 54880 | 2006-10-19 |
| 1134214398 | Kevin M Mikel | Dentist | 3312 Tower Avenue, Superior, WI 54880 | 2006-10-04 |
| Find all providers in zip 54880 | ||||
| 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 |
|---|---|---|---|---|
| 1679198113 | Gerald Thomas Mikel | Dentist | 3312 Tower Ave, Superior, WI 54880-5302 | 2020-06-10 |
| 1225584071 | Trent Sayers Dental PC | Dentist | 1691 Coalton Rd., Superior, CO 80027 | 2016-08-31 |
| 1386810521 | H. Douglas Clark Jr. | Dentist | 2101 Hill Ave, Superior, WI 54880-5260 | 2008-05-07 |
| 1982814885 | Melinda Harbin Meng | Dentist | 405 Brooklyn Ave, Superior, MT 59872-9607 | 2007-05-22 |
| 1538264395 | Roger Scott Mathis | Dentist | 444 Promenade Dr, Superior, CO 80027-8666 | 2006-09-14 |
| 1477669570 | Ronald Kent Scott | Dentist | 119 Belknap St, Superior, WI 54880-2925 | 2006-08-22 |
| 1376587279 | Richard Mathias Johnson | Dentist | 1507 Tower Ave, Rm 427, Superior, WI 54880 | 2006-06-15 |
| 1790394740 | Omran Zarou | Dentist | 823 Belknap St, Superior, WI 54880-2960 | 2020-07-27 |
| 1457845679 | Alexander James Mcneeley | Dentist | 306 Center Dr, Superior, CO 80027-8625 | 2018-06-20 |
| 1487169827 | Daniel Mease | Dentist | 306 Center Dr, Superior, CO 80027-8625 | 2017-12-07 |
| Find all providers in SUPERIOR | ||||
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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.