DR. MICHAEL KENNETH CLARK (NPI# 1619316403) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1619316403 |
| Entity Type | Individual |
| Full Name | DR. MICHAEL KENNETH CLARK |
| Credential | DDS |
| Practice Address |
27725 Santa Margarita Pkwy Suite 130 Mission Viejo CA 92691-6704 |
| Practice Telephone | 9494703672 |
| Practice Fax Number | 9494722095 |
| Mailing Telephone | 9494703672 |
| Mailing Fax Number | 9494722095 |
| Enumeration Date | 2013-06-14 |
| Last Update Date | 2013-06-14 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223S0112X |
Dentist Specialization: Oral and Maxillofacial Surgery |
41907 | CA | Dental Providers |
| 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 |
27725 SANTA MARGARITA PKWY SUITE 130 |
| City | MISSION VIEJO |
| State | CA |
| Zip Code | 92691-6704 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144213729 | Julie Ann Malley | Chiropractor | 27725 Santa Margarita Pkwy, Suite 201, Mission Viejo, CA 92691-6704 | 2005-08-29 |
| 1720538812 | Christopher Lin M.d. Inc. | Clinic/Center | 27725 Santa Margarita Pkwy, Suite 225, Mission Viejo, CA 92691-6704 | 2016-10-12 |
| 1043694391 | Robert A Milner Dds Dental Corporation | Dentist | 27725 Santa Margarita Pkwy, Suite 120, Mission Viejo, CA 92691-6704 | 2015-07-16 |
| 1316294457 | Christopher B Lin, Inc | Pediatrics | 27725 Santa Margarita Pkwy, Suite # 225, Mission Viejo, CA 92691-6704 | 2012-08-08 |
| 1518233402 | Paul H. Turek Dc Chiropractic Inc | Prosthetic/Orthotic Supplier | 27725 Santa Margarita Pkwy, Suite 100, Mission Viejo, CA 92691-6704 | 2012-03-26 |
| 1245493105 | Christine Tuong Linh Hoang | Dentist | 27725 Santa Margarita Pkwy, Suite 270, Mission Viejo, CA 92691 | 2008-07-09 |
| 1194914176 | J. Margo Jaffe Orr, M.d., Inc. | Internal Medicine | 27725 Santa Margarita Pkwy, Suite 220, Mission Viejo, CA 92691-6707 | 2007-10-16 |
| 1801087218 | Alamitos Dermatological Medical Clinic A Professional Corp | Specialist | 27725 Santa Margarita Pkwy, Suite 110, Mission Viejo, CA 92691-6704 | 2007-08-09 |
| 1205027869 | Pacific Pediatric Therapy | Clinic/Center | 27725 Santa Margarita Pkwy, Suite 221, Mission Viejo, CA 92691-6704 | 2007-08-07 |
| 1407055049 | Jeromy Dean Ratzlaff | Chiropractor | 27725 Santa Margarita Pkwy, Suite 120, Mission Viejo, CA 92691-6704 | 2007-07-13 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134748247 | Sonja Wood | Registered Nurse | 92691 Avenida Deseo, Mission Viejo, CA 92691 | 2020-04-09 |
| 1912488487 | Garfield Beach Cvs LLC | Durable Medical Equipment & Medical Supplies | 27551 Puerta Real, Mission Viejo, CA 92691 | 2018-08-23 |
| 1518457704 | Leon Baginski Md Inc | Obstetrics & Gynecology | 26800 Crown Valley Pkwy Ste 560, Mission Viejo, CA 92691 | 2018-05-14 |
| 1215426762 | Gail G Warner | Marriage & Family Therapist | 26050 Acero, Suite 301, Mission Viejo, CA 92691 | 2018-05-09 |
| 1508354176 | Tania Choudhary | Student in an Organized Health Care Education/Training Program | 23595 Rangoon St, Mission Viejo, CA 92691 | 2018-04-28 |
| 1710486519 | Aubriana Denise Gray | Counselor | 25802 Pacifica Ave, Mission Viejo, CA 92691 | 2018-02-07 |
| 1487162707 | Alberto Israel Galicia | Case Manager/Care Coordinator | 27261 Las Ramblas, Suite 220, Mission Viejo, CA 92691 | 2018-01-22 |
| 1629595244 | Elisabeth A Lischer | Counselor | 26137 La Paz Road, Suite 230, Mission Viejo, CA 92691 | 2017-08-24 |
| 1639694227 | Dr. Horiyat, A Dental Corporation | Dentist | 27652 Crown Valley Parkway, Mission Viejo, CA 92691 | 2017-08-04 |
| 1255851689 | Jackelin Liseth Martinez | Counselor | 25402 Pacifica Avenue, Mission Viejo, CA 92691 | 2017-06-27 |
| Find all providers in zip 92691 | ||||
| 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 |
|---|---|---|---|---|
| 1639562796 | Salib Medical A Professional Corporation | Dentist | 26732 Crown Valley Pkwy Ste 531, Mission Viejo, CA 92691-8526 | 2015-03-13 |
| 1093961575 | Mohammad Hossein Mohammadi-araghi | Dentist | 25571 Jeromino Rd, Suite 11, Mission Viejo, CA 92691 | 2008-08-15 |
| 1992108302 | Salib Dds Inc | Dentist | 26732 Crown Valley Pkwy, Suite 531, Mission Viejo, CA 92691-6306 | 2014-09-29 |
| 1932341955 | Jeffrey Marshall Caputo | Dentist | 26302 La Paz Rd Ste 102, Mission Viejo, CA 92691-5327 | 2009-04-06 |
| 1629282355 | Foothill Oral Surgery Center | Dentist | 27725 Santa Margarita Pkwy, Suite 130, Mission Viejo, CA 92691-6704 | 2007-05-10 |
| 1346387362 | Eduard Balasanian | Dentist | 26302 La Paz Rd, Suite 102, Mission Viejo, CA 92691-5313 | 2007-01-31 |
| 1043377856 | Jackson Moses, Dds, Inc | Dentist | 27800 Medical Center Rd, 238, Mission Viejo, CA 92691-6410 | 2007-01-02 |
| 1801975594 | Nader K. Salib | Dentist | 26732 Crown Valley Pkwy, Suite 531, Mission Viejo, CA 92691-6306 | 2006-11-03 |
| 1700962347 | Cummings, Balasanian, Caputo & Nicholls Dental Group, Inc. | Dentist | 26302 La Paz Rd, Suite 102, Mission Viejo, CA 92691-5313 | 2006-10-27 |
| 1427162932 | Jackson Moses | Dentist | 27800 Medical Center Rd, Suite 238, Mission Viejo, CA 92691-6410 | 2006-08-19 |
| Find all providers in MISSION VIEJO | ||||
| City | MISSION VIEJO |
| Zip Code | 92691 |
Please comment or provide details below to improve the information on DR. MICHAEL KENNETH 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.