DR. JENNIFER L. CLARK


Address: 501 S Main Ave, Aztec, NM 87410-2247
Phone: 5305208401

DR. JENNIFER L. CLARK (NPI# 1205189719) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1205189719
Entity Type Individual
Full Name DR. JENNIFER L. CLARK
Credential DDS, MSD
Practice Address 501 S Main Ave
Aztec
NM 87410-2247
Mailing Address 357 Clear Spring Ave
Durango
CO 81301-6615
Practice Telephone 5305208401
Mailing Telephone 5305208401
Enumeration Date 2012-10-22
Last Update Date 2016-05-05
Gender Code F
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 1223P0300X Dentist
Specialization: Periodontics
DEN.00202055 CO Dental Providers
N 1223P0300X Dentist
Specialization: Periodontics
59915 CA Dental Providers
Y 1223P0300X Dentist
Specialization: Periodontics
DD4420 NM Dental Providers

Other Providers JENNIFER CLARK

NPI Name Taxonomy Address Enumeration
1932723038 Jennifer Michelle Clark Social Worker 22 Norva Ave, Frederick, MD 21701-6279 2020-06-04
1982249926 Jennifer Rae Clark Nurse Practitioner 2800 E League City Pkwy Apt 216, League City, TX 77573-1676 2019-11-13
1528546827 Jennifer Clark Technician 59 Forrester St Sw Apt B, Washington, DC 20032-2120 2018-07-30
1265940340 Jennifer Anne Clark Counselor 35 Pulaski Rd, Whitehouse Station, NJ 08889-3516 2018-01-11
1598118572 Jennifer Clark Internal Medicine 1120 W. Michigan Street Gatch Hall Cl 630, Indianapolis, IN 46204 2016-07-14
1295124899 Jennifer Clark Behavioral Analyst 662 Lake George Dr, Melbourne, FL 32940-2221 2015-01-20
1851707194 Jennifer Sara Clark Physical Therapist 797 Evergreen Dr, West Hempstead, NY 11552-3406 2014-07-08
1083988794 Jennifer Makiki Clark Health Educator 5858 Wilshire Blvd Ste 300, Los Angeles, CA 90036-4509 2012-02-27
1639484520 Jennifer Ann Clark Speech-Language Pathologist 5903 Neptune Dr, Fort Collins, CO 80525-3905 2010-08-16
1245567247 Jennifer Selleck Clark Nurse Practitioner 1840 Martin Luther King Jr Blvd Ste C4, Chapel Hill, NC 27514 2009-11-11

Office Location

Street Address 501 S MAIN AVE
City AZTEC
State NM
Zip Code 87410-2247

Providers in the same location

NPI Name Taxonomy Address Enumeration
1679507859 Smilemaker Dental Inc. Dentist 501 S Main Ave, Aztec, NM 87410-2247 2006-07-11
1700029964 Douglas D. Parks Dentist 501 S Main Ave, Aztec, NM 87410-2247 2009-04-16

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1467095448 Kendill May Jones Technician 403 Andrew D, Aztec, NM 87410 2019-10-23
1831346469 Suzette Lorraine Gordon Psychologist 1607 W. Aztec Blvd., Aztec Municipal Schools, Aztec, NM 87410 2008-08-26
1730392101 Jack Fields Sona II Pharmacist Jack Sona, Rph, 100 Llano St, Aztec, NM 87410 2007-05-08
1093888380 Bryan Standley Poe Family Medicine 406 S Park Ave, Aztec, NM 87410 2006-11-16
1467531921 Katherine Andersen Acupuncturist 606 South Rio Grande Ave., Suite B, Aztec, NM 87410 2006-11-03
1861467433 San Juan Regional Medical Center Inc Internal Medicine 120 Llano St, Aztec, NM 87410 2006-02-17
1649262502 Kare Inc Pharmacy 100 Llano St., Aztec, NM 87410 2005-08-17
1871023044 Rebekah Leann French Nurse Practitioner 120 Llano St, Aztec, NM 87410 2017-06-19
1316486855 Sarah Anne Thomason Registered Nurse 1118 W Aztec Blvd, Aztec, NM 87410 2017-02-16
1629257092 Karen L Vogel Speech-Language Pathologist 455 N Light Plant Rd, Aztec, NM 87410-1517 2007-11-01
Find all providers in zip 87410

Taxonomy Information

Taxonomy Code 1223P0300X
Grouping Dental Providers
Classification Dentist
Specialization Periodontics

Taxonomy Definition

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

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1972118685 Southwest Periodontal and Implants Dentist 3045 E University Ave Ste A, Las Cruces, NM 88011-9147 2020-09-10
1316455017 Pino Periodontics, LLC Dentist 7007 Wyoming Blvd Ne Ste D1, Albuquerque, NM 87109-3981 2018-01-16
1407140361 Kevin Charles Harrison Dentist 10151 Montgomery Blvd Ne Ste C, Albuquerque, NM 87111-3670 2011-06-07
1023332350 Chun-xiao Sun Dentist 8501 Candelaria Rd Ne Ste D3, Albuquerque, NM 87112-1032 2010-03-15
1124287206 Redemption Dentist 4550 Eubank N.e., Suite 207, Albuquerque, NM 87111-2565 2008-06-04
1417122102 James Bradley Aday Dentist 2701 Missouri Ave Ste E, Las Cruces, NM 88011-5091 2008-04-24
1871681700 Albuquerque Implant & Periodontal Consultants. LLC Dentist 10425 Montgomery Pkwy Ne, Albuquerque, NM 87111-3864 2006-10-10
1306931035 Henry D Espinosa Dentist 10409 Montgomery Pkwy Ne #203, Albuquerque, NM 87111 2006-10-04
1851308290 Dianna R Montoya Dentist 1105 Golf Course Rd Se, Bld A, Rio Rancho, NM 87124-4733 2006-08-01
1356366975 Mark A. Ferrari Dentist 10250 Cottonwood Park Nw Ste B, Albuquerque, NM 87114-7019 2006-07-13
Find all providers with the same taxonomy

Competitor

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City AZTEC
Zip Code 87410

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Dataset Information

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.

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