Cyrus Bradford Clarke Jr., DMD

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

Practice address

740 S Limestone Room A262
Lexington, KY 40536

Phone

(859) 323-6723

Fax

(859) 323-2036

NPI assigned

Mar 27, 2018

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1522108800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1530144000000",
    "number": "1144725540",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "740 S LIMESTONE ROOM A262",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405360293",
            "telephone_number": "859-323-6723",
            "fax_number": "859-323-2036"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "740 S LIMESTONE ROOM A262",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "40536",
            "telephone_number": "859-323-6723",
            "fax_number": "859-323-2036"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARKE",
        "first_name": "CYRUS",
        "middle_name": "BRADFORD",
        "name_suffix": "Jr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-03-27",
        "last_updated": "2018-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "KY",
            "license": "10123",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shayna Clark
• Terry D Clark, M.D.
• Terry Lee Clark, LCSW
• Victoria Denise Clark
• Allison Dean Clarke, DPT
• Judith A Clarke, RN
• Julie Ann Clarke, LCSW
• Diana J Clarkson, RPH
• Mackenzie Fox Clasby, OTR/L
• Amy Claunch, APRN

• Student in an Organized Health Care Education/Training Program in Lexington, KY
• Providers in Lexington, KY by specialty
• Student in an Organized Health Care Education/Training Program in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2018; 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.