Clark Andrew Downey, D.D.S

Primary specialty

DentistTaxonomy code 122300000X

License

DN29676 Issued in FL

Practice address

6340 N Wickham Rd
Melbourne, FL 32940-2046

Phone

(321) 254-8119

NPI assigned

Aug 9, 2008

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Still Waters Family Dentistry, PC

  • Dentist
  • Ossian, IN
  • NPI 1326511189
  NPD (past) Authorized official

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

{
    "created_epoch": "1218240000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746057600000",
    "number": "1114173226",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6340 N WICKHAM RD",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329402046",
            "telephone_number": "321-254-8119"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6340 N WICKHAM RD",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329402046",
            "telephone_number": "321-254-8119"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOWNEY",
        "first_name": "CLARK",
        "middle_name": "ANDREW",
        "name_prefix": "Dr.",
        "credential": "D.D.S",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-08-09",
        "last_updated": "2025-05-01",
        "certification_date": "2025-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN29676",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jeannelle Douglas
• Daniel Vincent Dourney, PT
• Jorge Arnold Dovale Ricardo, DMD
• Peter Samo Dovgan, MD
• Brian Christopher Dowdell, MD
• Tara Downs
• Nicole C Doyle, APRN
• Dr Joseph D Paolucci MD PA LLC
• Dr Manohar G Reddy MD PA
• Dr. Pamela R. Heiple P.a.

• Dentist in Melbourne, FL
• Providers in Melbourne, FL by specialty
• Dentist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.