DR. JEV CLARK (NPI# 1558622936) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1558622936 |
| Entity Type | Individual |
| Full Name | DR. JEV CLARK |
| Practice Address |
120 Ramsgate Sq S Suite 110 Salem OR 97302-5868 |
| Practice Telephone | 5033716000 |
| Mailing Telephone | 5033716000 |
| Enumeration Date | 2012-06-01 |
| Last Update Date | 2018-04-19 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223S0112X |
Dentist Specialization: Oral and Maxillofacial Surgery |
D10561 | OR | Dental Providers |
| Street Address |
120 RAMSGATE SQ S SUITE 110 |
| City | SALEM |
| State | OR |
| Zip Code | 97302-5868 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174520548 | Martin J. Mehr | Dentist | 120 Ramsgate Sq S, Suite 110, Salem, OR 97302-5868 | 2005-06-30 |
| 1306961297 | Allan Steven Mehr | Audiologist-Hearing Aid Fitter | 120 Ramsgate Sq S, Salem, OR 97302-5868 | 2007-03-20 |
| 1700806445 | Allan Steven Mehr | Audiologist-Hearing Aid Fitter | 120 Ramsgate Sq S, Salem, OR 97302-5868 | 2006-07-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952954679 | Eric Anthony Bohm | Pharmacist | 2757 22nd St. Se, Salem, OR 97302 | 2019-07-22 |
| 1598223737 | Michael Robert Martini | Counselor | 960 Liberty Rd Se Suite 120, Salem, OR 97302 | 2019-03-06 |
| 1659857480 | Avalina Pharmacy Inc | Pharmacy | 3507 Commercial St Se, Salem, OR 97302 | 2018-07-16 |
| 1649762733 | Joseph Bochsler | Physical Therapist | 3220 Liberty Rd. S., Salem, OR 97302 | 2018-06-04 |
| 1922533652 | Brianne Elizabeth Sischo | Licensed Practical Nurse | 3871 Fairview Industrial Dr. Se Ste, 150, Salem, OR 97302 | 2017-05-01 |
| 1851825566 | Modern Nose Clinic LLC | Otolaryngology | 340 Vista Ave Se, Ste 100, Salem, OR 97302 | 2017-04-19 |
| 1720529803 | Nicholas Forsberg | Massage Therapist | 126 Mize Rd S, Salem, OR 97302 | 2017-03-09 |
| 1437691078 | Kimo Mahi | Specialist/Technologist, Other | 2373 Kuebler Rd. S, Salem, OR 97302 | 2016-11-14 |
| 1588113278 | New Life Family Medicine LLC | Clinic/Center | 842 Commercial Street Ne, Salem, OR 97302 | 2016-09-23 |
| 1073060117 | Susan Morag Robnett | Counselor | 912 Fir Street South, Salem, OR 97302 | 2016-09-07 |
| Find all providers in zip 97302 | ||||
| Taxonomy Code | 1223S0112X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Oral and Maxillofacial Surgery |
| The specialty of dentistry which includes the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831686468 | Jev A. Clark, Dmd, Md, LLC | Dentist | 120 Ramsgate Sq S Ste 110, Salem, OR 97302-5870 | 2018-04-19 |
| 1164712022 | Travis Jon Hamilton | Dentist | 250 Church St Se Ste 102, Salem, OR 97301-3758 | 2011-04-12 |
| 1124242813 | Dennis Douglas Johnson | Dentist | 410 Lancaster Dr Ne, Suite A, Salem, OR 97301-4794 | 2007-04-12 |
| 1407981855 | George Michael Koumaras | Dentist | 143 Bogey Ln, Salem, VA 24153-6858 | 2007-02-23 |
| 1578666426 | John C Tackett | Dentist | 102 N Harrison St, Salem, IN 47167-1426 | 2006-09-06 |
| 1609878172 | James M. Eyre Jr. | Dentist | 250 Church St Se, Ste 102, Salem, OR 97301-8500 | 2005-08-13 |
| 1588665723 | David Wesley Howerton | Dentist | 2266 Mission St Se, Salem, OR 97302-1267 | 2005-08-10 |
| 1447258223 | Gary Theodore Pederson | Dentist | 1565 Liberty St Se, Salem, OR 97302-4345 | 2005-07-14 |
| 1174520548 | Martin J. Mehr | Dentist | 120 Ramsgate Sq S, Suite 110, Salem, OR 97302-5868 | 2005-06-30 |
| 1972996197 | Southwest Virginia Oral & Maxillofacial Surgery, Pllc | Dentist | 1940 Braeburn Dr, Suite A, Salem, VA 24153-7383 | 2015-03-12 |
| Find all providers in SALEM | ||||
Please comment or provide details below to improve the information on DR. JEV CLARK.
| 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.