STEPHANIE CLARK (NPI# 1336792233) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1336792233 |
| Entity Type | Individual |
| Full Name | STEPHANIE CLARK |
| Credential | DDS |
| Practice Address |
5464 South St Ste A Lakewood CA 90712 |
| Mailing Address |
404 E 1st St # 197 Long Beach CA 90802-4903 |
| Practice Telephone | 2532793647 |
| Enumeration Date | 2019-07-19 |
| Last Update Date | 2019-07-19 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 122300000X | Dentist | 104042 | CA | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | 104042 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922612605 | Stephanie Clark | Massage Therapist | 15227 Spring Cor, San Antonio, TX 78247-1693 | 2020-09-01 |
| 1811516156 | Stephanie Clark | Social Worker | 10185 Isle St, Parker, CO 80134-5788 | 2020-04-15 |
| 1306486444 | Stephanie Clark | Licensed Practical Nurse | 636 Clay Ave Uppr, Rochester, NY 14613-1030 | 2020-01-07 |
| 1841681046 | Stephanie Clark | Technician, Other | 2917 S Ash Ct, Broken Arrow, OK 74012-7804 | 2015-02-09 |
| 1760816326 | Stephanie Diane Clark | Case Manager/Care Coordinator | 4613 Se 41st St, Del City, OK 73115-3703 | 2013-08-30 |
| 1538447560 | Stephanie Renae Clark | Physical Therapist | 927 Battlefield Blvd N, Suite 200, Chesapeake, VA 23320-4853 | 2011-07-25 |
| 1932330545 | Stephanie D Clark | Social Worker | 16581 Us Highway 17 N Ste 600, Hampstead, NC 28443-7451 | 2009-07-30 |
| 1487719787 | Stephanie Clark | Licensed Practical Nurse | 55 Ramble Hill Lane, Millbrook, NY 12545 | 2006-12-27 |
| 1811057425 | Stephanie Clark | Dentist | 7601 A Germantown Ave, Philadelphia, PA 19119 | 2006-12-12 |
| 1700864733 | Stephanie Elaine Clark | Audiologist | 13934 N 59th Ave, Ste 120, Glendale, AZ 85306-4167 | 2006-01-09 |
| Street Address |
5464 SOUTH ST STE A |
| City | LAKEWOOD |
| State | CA |
| Zip Code | 90712 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194060046 | Carolyn Wahby | Dentist | 5464 South St, Lakewood, CA 90712-1354 | 2012-12-04 |
| 1124369186 | Maria Paz Dulay | Dentist | 5464 South St, Lakewood, CA 90712 | 2013-03-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689289944 | Createwellness LLC | Social Worker | 5250 Hayter Avenue, Lakewood, CA 90712 | 2020-09-14 |
| 1801451398 | Marilou Toquero Dental Corp | Durable Medical Equipment & Medical Supplies | 3203 Carson St Suite 2, Lakewood, CA 90712 | 2019-05-09 |
| 1225510126 | N Ozder Dental Practice Inc | Clinic/Center | 5037 Lakewood Blvd, Lakewood, CA 90712 | 2018-09-06 |
| 1003394446 | Robert Michael Schlesinger | Counselor | 5150 Candlewood St Ste 13a, Lakewood, CA 90712 | 2018-07-28 |
| 1316439847 | P.r.i.s.m. Institute Inc. | Chiropractor | 5233 Premiere Ave, Lakewood, CA 90712 | 2018-05-31 |
| 1316477938 | Broadleaf Healthcare | Orthotist | 4345 Levelside Ave, Lakewood, CA 90712 | 2017-06-15 |
| 1679008049 | Adrienne Yoshiko Doi | Podiatrist | 3700 East South Street, Lakewood, CA 90712 | 2017-04-24 |
| 1841747334 | Garrison R Weaver-gourdeau | Chiropractor | 4115 E. South St, Lakewood, CA 90712 | 2016-09-01 |
| 1073967394 | Mirna S Rizkalla | Family Medicine | 3650 South St Ste 404, Lakewood, CA 90712 | 2016-04-22 |
| 1841657251 | Roxanna Jimenez | Rehabilitation Practitioner | 5818 Clark Ave, Lakewood, CA 90712 | 2016-01-15 |
| Find all providers in zip 90712 | ||||
| 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 |
|---|---|---|---|---|
| 1760025894 | Lakewood Dental Associates, LLC | Dentist | 838 River Ave Ste 1, Lakewood, NJ 08701-5279 | 2019-10-22 |
| 1851933287 | Jeri A. Logan | Dentist | 8064 W Jewell Ave Unit 100, Lakewood, CO 80232-6710 | 2019-10-17 |
| 1457838294 | Narges Lotfizadeh Dehkordi | Dentist | 5605 Lakewood Towne Center Blvd Sw Ste B, Lakewood, WA 98499-3855 | 2018-07-24 |
| 1770069239 | Jeffrey A. Osborn | Dentist | 8520 Steilacoom Blvd Sw Ste 202, Lakewood, WA 98498-4773 | 2018-07-17 |
| 1790279743 | Andrew Montalvo | Dentist | 12375 W Auburn Dr, Lakewood, CO 80228-4747 | 2018-06-21 |
| 1508376906 | Green Gables Dental LLC | Dentist | 7586 W Jewell Ave # 2-303, Lakewood, CO 80232-6890 | 2017-10-11 |
| 1073964284 | Travis Jay Barr | Dentist | 3333 S Wadsworth Blvd Unit D305, Lakewood, CO 80227-5142 | 2016-06-29 |
| 1285094672 | Danijela Jankovic | Dentist | 7611 W.colfax Avenue, Suite D, Lakewood, CO 80214 | 2016-02-29 |
| 1831556117 | John Kim | Dentist | 10011 Bridgeport Way Sw, Ste 700, Lakewood, WA 98499-2332 | 2016-01-18 |
| 1811361751 | Simple Smiles, Pllc | Dentist | 225 S Sheridan Blvd Ste 114, Lakewood, CO 80226-2405 | 2015-11-16 |
| Find all providers in LAKEWOOD | ||||
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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.