NPIMap

Organization Active NPI

Michael E Clarke Ddsms Inc

Doing business as Michael E. Clarke DDSMS

  • Oral and Maxillofacial Pathology Dentistry
  • Wailuku, HI
National Provider Identifier
1073644068
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Pathology DentistryTaxonomy code 1223P0106X
Legal business name
MICHAEL E CLARKE DDSMS INC
Doing business as
Michael E. Clarke DDSMS
Practice address
24 N Church St
Suite 206
Wailuku, HI 96793-1680
Phone
(808) 242-0077
Fax
(808) 243-8007
NPI assigned
Mar 8, 2007
Last updated
Jul 21, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Michael Ellsworth Clarke, D.D.S.,M. S.NPI 1316908296
Title
Owner
Phone
(808) 242-0077

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Pathology DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223P0106X HI Primary

Addresses

Primary practice location

24 N Church St
Suite 206
Wailuku, HI 96793-1680

Mailing address

24 N Church St
Suite 206
Wailuku, HI 96793-1680
Phone (808) 242-0077

Other identifiers 3

IdentifierTypeStateIssuer
526220-01MedicaidHI
00C0059976OtherHIHAWAII MEDICAL SERVICE AS
1439OtherHIHAWAII DENTAL SERVICE

Other names 1

  • Michael E. Clarke DDSMS Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1173312000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1073644068",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24 N CHURCH ST",
            "address_2": "SUITE 206",
            "city": "WAILUKU",
            "state": "HI",
            "postal_code": "967931680",
            "telephone_number": "808-242-0077",
            "fax_number": "808-243-8007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24 N CHURCH ST",
            "address_2": "SUITE 206",
            "city": "WAILUKU",
            "state": "HI",
            "postal_code": "967931680",
            "telephone_number": "808-242-0077",
            "fax_number": "808-243-8007"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHAEL E CLARKE DDSMS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-08",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "CLARKE",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "ELLSWORTH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "808-242-0077",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S.,M. S."
    },
    "taxonomies": [
        {
            "code": "1223P0106X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Oral and Maxillofacial Pathology",
            "state": "HI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "526220-01",
            "state": "HI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HAWAII MEDICAL SERVICE AS",
            "identifier": "00C0059976",
            "state": "HI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HAWAII DENTAL SERVICE",
            "identifier": "1439",
            "state": "HI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Michael E. Clarke DDSMS",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Wailuku, HI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.