James Clark & Associates, PC

Primary specialty

DentistTaxonomy code 122300000X

License

7917 Issued in NC

Legal business name

JAMES CLARK & ASSOCIATES, PC

Practice address

711 N Brown St
Chadbourn, NC 28431-1307

Phone

(910) 516-2067

Fax

(910) 516-2161

NPI assigned

Feb 19, 2016

Organization subpart

No

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

Authorized official

Name

Bebe Gunter Jackson

Title

Office Manager

Phone

(910) 863-2377

Specialties & licenses 2

Addresses

Other names 1

• Chadbourn Dental Care Doing business as

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

{
    "created_epoch": "1455840000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1455840000000",
    "number": "1073972964",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "711 N BROWN ST",
            "city": "CHADBOURN",
            "state": "NC",
            "postal_code": "284311307",
            "telephone_number": "910-516-2067",
            "fax_number": "910-516-2161"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "711 N BROWN ST",
            "city": "CHADBOURN",
            "state": "NC",
            "postal_code": "284311307",
            "telephone_number": "910-516-2067",
            "fax_number": "910-516-2161"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JAMES CLARK & ASSOCIATES, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-02-19",
        "last_updated": "2016-02-19",
        "status": "A",
        "authorized_official_last_name": "JACKSON",
        "authorized_official_first_name": "BEBE",
        "authorized_official_middle_name": "GUNTER",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "910-863-2377"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "NC",
            "license": "7917",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "NC",
            "license": "9752",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Chadbourn Dental Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• All providers in Chadbourn, NC
• Dentist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2016; 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.