NPIMap

Organization Active NPI

Donald E. Clarke, D.D.S., Inc.

Doing business as Dental Source of California

  • Dental Clinic/Center
  • Folsom, CA
National Provider Identifier
1083362537
Registry record updated May 16, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
Legal business name
DONALD E. CLARKE, D.D.S., INC.
Doing business as
Dental Source of California
Practice address
25005 Blue Ravine Rd Ste 100
Folsom, CA 95630-5706
Phone
(916) 600-3719
NPI assigned
Mar 14, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 16, 2022

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

Authorized official

Name
Dr. Donald Clarke, DDSNPI 1750615910
Title
President of Corporation
Phone
(916) 487-0117

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X Primary

Addresses

Primary practice location

25005 Blue Ravine Rd Ste 100
Folsom, CA 95630-5706

Mailing address

3901 Marconi Ave
Sacramento, CA 95821-3902
Phone (916) 487-0117

Other names 1

  • Dental Source of California Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Dental Source of California9 organizations share this tax ID, including this one

Other organizations with this tax ID 8

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

Locations

3901 Marconi Ave
Sacramento, CA 95821
Phone (916) 487-7995

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": "1647216000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1652659200000",
    "number": "1083362537",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3901 MARCONI AVE",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958213902",
            "telephone_number": "916-487-0117"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25005 BLUE RAVINE RD STE 100",
            "city": "FOLSOM",
            "state": "CA",
            "postal_code": "956305706",
            "telephone_number": "916-600-3719"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DONALD E. CLARKE, D.D.S., INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-03-14",
        "last_updated": "2022-05-16",
        "certification_date": "2022-03-25",
        "status": "A",
        "authorized_official_last_name": "CLARKE",
        "authorized_official_first_name": "DONALD",
        "authorized_official_title_or_position": "PRESIDENT OF CORPORATION",
        "authorized_official_telephone_number": "916-487-0117",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dental Source of California",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Dental Source of California",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Folsom, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 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.