MICHAEL CLARK (NPI# 1477694123) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1477694123 |
| Entity Type | Individual |
| Full Name | MICHAEL CLARK |
| Credential | RDH |
| Practice Address |
11 Norwich St Suite # 3 Worcester MA 01608-2421 |
| Practice Telephone | 5087551119 |
| Practice Fax Number | 5087551172 |
| Mailing Telephone | 5087551119 |
| Mailing Fax Number | 5087551172 |
| Enumeration Date | 2007-02-08 |
| Last Update Date | 2011-12-21 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 124Q00000X | Dental Hygienist | DH10401 | MA | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MA | 1301071 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215534227 | Michael Clark | Contractor | 1107 Lavender Shade Court, Houston, TX 77073 | 2020-10-02 |
| 1558858464 | Michael Clark | Optometrist | 990 Medical Dr Ste G3, Brigham City, UT 84302 | 2018-04-16 |
| 1740780006 | Michael Ryan Clark | Pharmacist | 556 Northside Drive, Statesboro, GA 30458 | 2018-02-13 |
| 1942715255 | Michael Clark | Physical Medicine & Rehabilitation | 10600 Riverside Drive, Coral Springs, FL 33071-3307 | 2017-12-08 |
| 1386170348 | Michael Clark | Registered Nurse | 317 E 100 N, Price, UT 84501-2504 | 2017-05-11 |
| 1184163982 | Michael Clark | Specialist/Technologist | 19 Second Ave, Auburn, NY 13021-5113 | 2017-02-14 |
| 1356780837 | Michael Clark | Adult Companion | 8305 Concord Dr, Rowlett, TX 75089-2001 | 2013-06-18 |
| 1417394503 | Michael Ray Clark | Pharmacist | 2661 Valleydale Rd, Hoover, AL 35244-2026 | 2013-05-29 |
| 1407143381 | Michael Jeffery Clark | Orthopaedic Surgery | 5671 Peachtree Dunwoody Ste 700, Atlanta, GA 30342-5047 | 2011-06-29 |
| 1700183993 | Michael Brady Clark | Preventive Medicine | 1400 Mckean Rd, Spring House, PA 19477 | 2011-02-24 |
| Street Address |
11 NORWICH ST SUITE # 3 |
| City | WORCESTER |
| State | MA |
| Zip Code | 01608-2421 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649451675 | Hameeda Hirani | Dentist | 11 Norwich St, Suite #3, Worcester, MA 01608-2421 | 2007-11-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033721733 | Rebecca Smith Morgan | Physical Therapist | Easter Seals Massachusetts, 484 Main St, Worcester, MA 01608 | 2020-08-24 |
| 1083244057 | Marc Labb | Counselor | 25 Union St 3rd Floor, Worcester, MA 01608 | 2020-01-18 |
| 1154974145 | Shanil Shah | Student in an Organized Health Care Education/Training Program | St Vincent Hospital, Department of Internal Medicine, 123 Summer Street, Worcester, MA 01608 | 2019-07-19 |
| 1194377069 | Varun Kommalapati | Student in an Organized Health Care Education/Training Program | St Vincent Hospital, 123 Summer Street, Worcester, MA 01608 | 2019-07-11 |
| 1992361182 | Jenna Recko | Physical Therapy Assistant | Easter Seals of Massachusetts, 484 Main St, Worcester, MA 01608 | 2019-05-14 |
| 1619452646 | Kara Thompson | Registered Nurse | 100 Martin Luther King Jr Blvd, Worcester, MA 01608 | 2018-09-25 |
| 1427555325 | Baran Umut Vardar | Student in an Organized Health Care Education/Training Program | 123 Summer Street, Saint Vincent Hospital Radiology Dep, Worcester, MA 01608 | 2018-04-09 |
| 1609380765 | Mary Elizabeth O'donnell | Occupational Therapist | Easter Seals Ma, 484 Main Street, Worcester, MA 01608 | 2017-11-28 |
| 1093227316 | Oasis Home Care, LLC | Home Health | 340 Main St Ste 803, Worcester, MA 01608 | 2017-10-26 |
| 1912437500 | Peter A Rondon | Social Worker | 11 Sycamore Street, Worcester, MA 01608 | 2017-06-15 |
| Find all providers in zip 01608 | ||||
| Taxonomy Code | 124Q00000X |
| Grouping | Dental Providers |
| Classification | Dental Hygienist |
| An individual who has completed an accredited dental hygiene education program, and an individual who has been licensed by a state board of dental examiners to provide preventive care services under the supervision of a dentist. Functions that may be legally delegated to the dental hygienist vary based on the needs of the dentist, the educational preparation of the dental hygienist and state dental practice acts and regulations, but always include, at a minimum, scaling and polishing the teeth. To avoid misleading the public, no occupational title other than dental hygienist should be used to describe this dental auxiliary. |
| Notes: Source: Comprehensive Policy Statement on Dental Auxiliaries, American Dental Association. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346704889 | Jamie Ellen Russell | Dental Hygienist | 26 Queen St Ste 13, Worcester, MA 01610-2478 | 2019-01-29 |
| 1790265601 | Heidi E Ebers | Dental Hygienist | 19 Tacoma St, Worcester, MA 01605-3516 | 2018-08-20 |
| 1174869036 | Deborah Marie Johnstone | Dental Hygienist | 26 Queen St, Worcester, MA 01610-2473 | 2012-12-21 |
| 1306182241 | Stephenie Pokorney | Dental Hygienist | 26 Queen St, Worcester, MA 01610-2473 | 2012-12-21 |
| 1437495363 | Mai Le | Dental Hygienist | 26 Queen St, Worcester, MA 01610-2473 | 2012-12-20 |
| 1396081469 | Caroline Banks Luzi | Dental Hygienist | 26 Queen St, Worcester, MA 01610-2473 | 2012-12-18 |
| 1306144654 | Waldina Lizette Yarzebski | Dental Hygienist | 19 Tacoma St, Worcester, MA 01605-3516 | 2011-03-10 |
| 1184860850 | Amy B Fantoni | Dental Hygienist | 670 W Boylston St, Worcester, MA 01606-2064 | 2008-12-30 |
| 1477702363 | Meaghan M Coull | Dental Hygienist | 19 Tacoma St, Worcester, MA 01605-3516 | 2008-09-16 |
| 1982877122 | Rachel Mungovan | Dental Hygienist | 19 Tacoma St, Worcester, MA 01605-3516 | 2008-04-09 |
| Find all providers in WORCESTER | ||||
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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.