CLARK DENTAL P.C. (NPI# 1902321045) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1902321045 |
| Entity Type | Organization |
| Organization Name | CLARK DENTAL P.C. |
| Practice Address |
10597 S Beach Comber Way South Jordan UT 84009-6132 |
| Practice Telephone | (208) 317-8555 |
| Mailing Telephone | 2083178555 |
| Enumeration Date | 2017-08-10 |
| Last Update Date | 2017-08-10 |
| Authorized Official Name | TANNER MARK CLARK (PRESIDENT) |
| Authorized Official Telephone | 2083178555 |
| Authorized Official Credential | DMD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
9860439-9921 | UT | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| UT | 3003062 | 05 |
| Street Address |
10597 S BEACH COMBER WAY |
| City | SOUTH JORDAN |
| State | UT |
| Zip Code | 84009-6132 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386277689 | Senior Smiles Utah LLC | Dentist | 10597 S Beach Comber Way, South Jordan, UT 84009-6132 | 2020-02-15 |
| 1821621129 | Pro Smiles Utah LLC | Dentist | 10597 S Beach Comber Way, South Jordan, UT 84009-6132 | 2020-02-15 |
| 1679055081 | Smart Smiles Utah | Dentist | 10597 S Beach Comber Way, South Jordan, UT 84009-6132 | 2018-08-31 |
| 1386143857 | Denticare, LLC | Clinic/Center | 10597 S Beach Comber Way, South Jordan, UT 84009-6132 | 2018-02-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104347061 | Pony Express Dental Daybreak, LLC | Clinic/Center | 5396 W Daybreak Parkway, South Jordan, UT 84009 | 2017-06-30 |
| 1831630763 | Tina Patel | Dentist | 11501 S 4000 W Ste 101, South Jordan, UT 84009 | 2017-03-10 |
| 1811396260 | Out of This World Dentistry Sj PC | Dentist | 10426 S. 4000 W., South Jordan, UT 84009 | 2014-08-21 |
| 1184970956 | Robert Owyn Lindquist IIi | Social Worker | 10609 S. Granby Way, South Jordan, UT 84009 | 2012-07-31 |
| 1013138254 | Kelly Kristen Adams | Pediatrics | 4686 W Crosswater Road, South Jordon, UT 84009 | 2007-05-02 |
| 1760081061 | Someone To Talk To | Psychologist | 10352 S Sturgeon Dr, South Jordan, UT 84009-1218 | 2020-10-19 |
| 1699317685 | Daybreak Pdc Pllc | Dentist | 4040 West Daybreak Pkwy, Suite 103, South Jordan, UT 84009-1286 | 2019-10-11 |
| 1518414911 | Charli Danielle Peters | Nurse Practitioner | 9636 S Skye Park Rd, South Jordan, UT 84009-1506 | 2016-09-02 |
| 1760933832 | Naomi Mackert | Massage Therapist | 4988 W Wood Ranch Dr, South Jordan, UT 84009-1532 | 2016-10-24 |
| 1396285425 | Preston Howard Catmull | Physical Therapist | 9988 S Hook Dr, South Jordan, UT 84009-2786 | 2017-03-08 |
| Find all providers in zip 84009 | ||||
| Taxonomy Code | 1223G0001X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | General Practice |
| A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. |
| Notes: Source: Academy of General Dentistry |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700409695 | Wasatch Dental Group LLC | Dentist | 1685 W Towne Center Dr, South Jordan, UT 84095-8697 | 2020-05-26 |
| 1760022768 | Sojo Dental | Dentist | 3473 W South Jordan Parkway, Ste. 2, South Jordan, UT 84095-6016 | 2020-01-08 |
| 1730745456 | Michael Thomas | Dentist | 4775 W Daybreak Pkwy Ste 201, South Jordan, UT 84009-5140 | 2019-05-17 |
| 1710479795 | Lee Hoang Mai | Dentist | 3672 W South Jordan Pkwy Ste 104, South Jordan, UT 84009-7172 | 2018-06-05 |
| 1063949782 | Joby Chaluparambil | Dentist | 11758 S District Dr, Unit 702, South Jordan, UT 84095-6041 | 2017-05-11 |
| 1871978981 | Jacob Boyack | Dentist | 2651 W South Jordan Pkwy Ste 203, South Jordan, UT 84095-8968 | 2015-07-30 |
| 1427452614 | Genesis Dental of Riverton | Dentist | 11428 South Parkway Plaza Drive, Suite 400, South Jordan, UT 84095 | 2014-10-16 |
| 1336573120 | James R Donahoo | Dentist | 10894 S. River Front Parkway, South Jordan, UT 84095 | 2013-08-28 |
| 1881953966 | David Densley | Dentist | Roseman University, 10920 S River Front Pkwy, South Jordan, UT 84095 | 2012-05-10 |
| 1346510054 | Richard D Tuttle | Dentist | 505 W 10200 S, South Jordan, UT 84095-3935 | 2012-01-11 |
| Find all providers in SOUTH JORDAN | ||||
| City | SOUTH JORDAN |
| Zip Code | 84009 |
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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.