David a Clark DDS PLLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DE60023580 Issued in WA

Legal business name

DAVID A CLARK DDS PLLC

Practice address

4209 Tieton Dr Ste 102
Yakima, WA 98908-3377

Phone

(509) 966-2230

Fax

(509) 966-8812

NPI assigned

Jan 30, 2014

Organization subpart

No

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

Authorized official

Name

David A Clark

Title

Owner

Phone

(509) 966-2230

Specialties & licenses 1

Addresses

Tax ID family

David a Clark DDS PLLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• David a Clark DDS PLLC

  • Dentist
  • Yakima, WA
  • NPI 1053617308
  NPD tax ID

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

{
    "created_epoch": "1391040000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1391040000000",
    "number": "1073936837",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4209 TIETON DR STE 102",
            "city": "YAKIMA",
            "state": "WA",
            "postal_code": "989083377",
            "telephone_number": "509-966-2230",
            "fax_number": "509-966-8812"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4209 TIETON DR STE 102",
            "city": "YAKIMA",
            "state": "WA",
            "postal_code": "989083377",
            "telephone_number": "509-966-2230",
            "fax_number": "509-966-8812"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAVID A CLARK DDS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-01-30",
        "last_updated": "2014-01-30",
        "status": "A",
        "authorized_official_last_name": "CLARK",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "509-966-2230"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "WA",
            "license": "DE60023580",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Andrew Allan Davenport, D.O.
• Ariella Davenport
• Nathaniel A Davenport, MD
• Peggy Davenport
• David a Clark DDS PLLC
• David E Moore DDS, PS
• David R Brown DDS PS
• Renee David, LICSW
• Ryan James David, D.O.
• Eileen Davidson

• General Practice Dentistry in Yakima, WA
• Providers in Yakima, WA by specialty
• General Practice Dentistry in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2014; 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.