Active NPI
Adam M Clark, DMD
- Prosthodontics
- Charleston, SC
National Provider Identifier
1003086224
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Prosthodontics
- License
- 3728545
- Practice address
- 1416 Ashley River Rd
Atlantic Aesthetics
Charleston, SC 29407-5306 - Phone
- (843) 769-0488
- Fax
- (843) 769-0428
- NPI assigned
- Mar 4, 2008
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Prosthodontics | 1223P0700X | 3728545 | SC | Primary |
Addresses
Primary practice location
1416 Ashley River Rd
Atlantic Aesthetics
Charleston, SC 29407-5306
Mailing address
1416 Ashley River Rd
Atlantic Aesthetics
Charleston, SC 29407-5306
Phone (843) 769-0488
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3728545 | SC | MD | Prosthodontist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1204588800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1204588800000",
"number": "1003086224",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1416 ASHLEY RIVER RD",
"address_2": "ATLANTIC AESTHETICS",
"city": "CHARLESTON",
"state": "SC",
"postal_code": "294075306",
"telephone_number": "843-769-0488",
"fax_number": "843-769-0428"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1416 ASHLEY RIVER RD",
"address_2": "ATLANTIC AESTHETICS",
"city": "CHARLESTON",
"state": "SC",
"postal_code": "294075306",
"telephone_number": "843-769-0488",
"fax_number": "843-769-0428"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CLARK",
"first_name": "ADAM",
"middle_name": "M",
"credential": "DMD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2008-03-04",
"last_updated": "2008-03-04",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0700X",
"taxonomy_group": "",
"desc": "Dentist, Prosthodontics",
"state": "SC",
"license": "3728545",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Charleston, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.