NPIMap

Organization Active NPI

Dr. Darrll Adrian Clark D.D.S.

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • California, MD
National Provider Identifier
1093916702
Registry record updated Jul 12, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
License
8308 Issued in MD
Legal business name
DR. DARRLL ADRIAN CLARK D.D.S.
Practice address
45111 First Colony Way
California, MD 20619-2416
Phone
(301) 866-9850
NPI assigned
May 30, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 12, 2011

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

Authorized official

Name
Dr. Darrell Adrian Clark, D.D.S. P.A.
Title
President
Phone
(301) 218-1622

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223X0400X 8308 MD Primary

Addresses

Primary practice location

45111 First Colony Way
California, MD 20619-2416

Mailing address

3102 Dunkagle CT
Bowie, MD 20721-1261
Phone (301) 218-1622

National Provider Directory

National Provider Directory
Tax ID family
Dr Darrell Adrian Clark DDS3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

Locations

45111 First Colony Way
California, MD 20619
Phone (301) 866-9850

NPI Registry JSON

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

{
    "created_epoch": "1180483200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1310428800000",
    "number": "1093916702",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3102 DUNKAGLE CT",
            "city": "BOWIE",
            "state": "MD",
            "postal_code": "207211261",
            "telephone_number": "301-218-1622",
            "fax_number": "301-218-1623"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "45111 FIRST COLONY WAY",
            "city": "CALIFORNIA",
            "state": "MD",
            "postal_code": "206192416",
            "telephone_number": "301-866-9850"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR. DARRLL ADRIAN CLARK D.D.S.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-30",
        "last_updated": "2011-07-12",
        "status": "A",
        "authorized_official_last_name": "CLARK",
        "authorized_official_first_name": "DARRELL",
        "authorized_official_middle_name": "ADRIAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "301-218-1622",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S. P.A."
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "MD",
            "license": "8308",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in California, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2011; 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.