JESSICA M. CLARK, DDS, P.C. (NPI# 1902261233) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1902261233 |
| Entity Type | Organization |
| Organization Name | JESSICA M. CLARK, DDS, P.C. |
| Practice Address |
1300 Kempsville Rd Ste 5 Virginia Beach VA 23464-6199 |
| Practice Telephone | 7574677797 |
| Mailing Telephone | 7574677797 |
| Mailing Fax Number | 7574741493 |
| Enumeration Date | 2015-12-31 |
| Last Update Date | 2015-12-31 |
| Authorized Official Name | JESSICA M. CLARK (OWNER) |
| Authorized Official Telephone | 7574677797 |
| Authorized Official Credential | DDS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223P0221X |
Dentist Specialization: Pediatric Dentistry |
0401414334 | VA | Dental Providers |
| Street Address |
1300 KEMPSVILLE RD STE 5 |
| City | VIRGINIA BEACH |
| State | VA |
| Zip Code | 23464-6199 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760794309 | Jessica Michelle Clark | Dentist | 1300 Kempsville Rd Ste 5, Virginia Beach, VA 23464-6199 | 2010-07-12 |
| 1235642828 | Jessica M. Clark, Dds | Dentist | 1300 Kempsville Rd Ste 5, Virginia Beach, VA 23464-6199 | 2017-11-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437610581 | Ainsley's Angels of America | Durable Medical Equipment & Medical Supplies | 828 Cabrini Place, Virginia Beach, VA 23464 | 2019-03-29 |
| 1104313055 | Your Family Is Family Home Healthcare Services, LLC | Respite Care | 1311 Hafford Road, Virginia Beach, VA 23464 | 2018-04-17 |
| 1497274765 | Jamie Crisman | Occupational Therapist | 1400 Fordham Drive, Virginia Beach, VA 23464 | 2017-09-18 |
| 1861919334 | Joshua Hoxter | Chiropractor | 6070 Indian River Rd Ste 102, Virginia Beach, VA 23464 | 2017-08-25 |
| 1669909917 | Toni Faye Tayag | Specialist/Technologist | 909 Tidemark Court, Virginia Beach, VA 23464 | 2017-05-17 |
| 1922545540 | Divinefavor LLC | Non-emergency Medical Transport (VAN) | 1014 Level Green Blvd, Virginia Beach, VA 23464 | 2017-01-20 |
| 1326499807 | David Klucznik | Dentist | 5564 Indian River Road, Virginia Beach, VA 23464 | 2016-06-27 |
| 1093161374 | Mawussi Komi | General Acute Care Hospital | 6271 Drew Dr, Va Beach, VA 23464 | 2016-05-05 |
| 1588071807 | Linda Mathis | Skilled Nursing Facility | 5520 Indian Road, Virginia Beach, VA 23464 | 2014-07-18 |
| 1083045561 | Manny-nelson Med LLC | Durable Medical Equipment & Medical Supplies | 1612 Centerville Turnpike, Suite 308, Virginia Beach, VA 23464 | 2013-12-09 |
| Find all providers in zip 23464 | ||||
| Taxonomy Code | 1223P0221X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Pediatric Dentistry |
| An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760794309 | Jessica Michelle Clark | Dentist | 1300 Kempsville Rd Ste 5, Virginia Beach, VA 23464-6199 | 2010-07-12 |
| 1467629048 | Bukola Oduyelu, Dds, PC | Dentist | 2264 London Bridge Rd, Virginia Beach, VA 23456-3903 | 2008-05-13 |
| 1811011042 | Townsend Brown Jr., D.d.s. | Dentist | 1300 Kempsville Road, Suite 5, Virginia Beach, VA 23464 | 2007-03-16 |
| 1568579399 | Scott H Rosenblum | Dentist | 1055 Kempsville Rd, Virginia Beach, VA 23464-5501 | 2006-08-25 |
| 1871535872 | Townsend Brown Jr. | Dentist | 1300 Kempsville Rd, Suite 5, Virginia Beach, VA 23464-6199 | 2006-06-12 |
| 1700840816 | Olubukunola A Oduyelu | Dentist | 2125 Mccomas Way, Suite 105, Virginia Beach, VA 23456-3986 | 2006-04-14 |
| 1235642828 | Jessica M. Clark, Dds | Dentist | 1300 Kempsville Rd Ste 5, Virginia Beach, VA 23464-6199 | 2017-11-06 |
| 1811300460 | Amy Namsupak | Dentist | 2100 Lynnhaven Pkwy, Suite 200, Virginia Beach, VA 23456-1492 | 2014-06-10 |
| 1477842243 | David J Herce | Dentist | 2100 Lynnhaven Pkwy, #200, Virginia Beach, VA 23456-1492 | 2011-04-01 |
| 1932277506 | Rosenblum, Levin, Barney & Hasty, Ltd | Dentist | 1055 Kempsville Rd, Virginia Beach, VA 23464-5501 | 2006-12-01 |
| Find all providers in VIRGINIA BEACH | ||||
| City | VIRGINIA BEACH |
| Zip Code | 23464 |
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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.