NPIMap

Organization Active NPI

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

  • Dental Clinic/Center
  • Modesto, CA
National Provider Identifier
1104156744
Registry record updated Jan 4, 2010
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.
Practice address
1015 5TH St
Modesto, CA 95351-2810
Phone
(209) 577-4263
Fax
(209) 577-2056
NPI assigned
Jan 4, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 4, 2010

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

Authorized official

Name
Dr. Donald Clarke, D.D.S.
Title
Corporation President
Phone
(916) 487-0117

Specialties & licenses 1

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

Addresses

Primary practice location

1015 5TH St
Modesto, CA 95351-2810

Mailing address

1015 5TH St
Modesto, CA 95351-2810
Phone (209) 577-4263

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

1015 5th St
Modesto, CA 95351
Phone (209) 577-4263

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1262563200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1262563200000",
    "number": "1104156744",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1015 5TH ST",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953512810",
            "telephone_number": "209-577-4263",
            "fax_number": "209-577-2056"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1015 5TH ST",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953512810",
            "telephone_number": "209-577-4263",
            "fax_number": "209-577-2056"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DONALD E. CLARKE, D.D.S., INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-01-04",
        "last_updated": "2010-01-04",
        "status": "A",
        "authorized_official_last_name": "CLARKE",
        "authorized_official_first_name": "DONALD",
        "authorized_official_title_or_position": "CORPORATION PRESIDENT",
        "authorized_official_telephone_number": "916-487-0117",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "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"
        }
    ]
}

Other providers in Modesto, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2010; 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.