Christopher Michael Clark, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

11854 Issued in NC

Practice address

8815 Christenbury Pkwy Ste 40
Concord, NC 28027-0261

Phone

(704) 264-0253

NPI assigned

Apr 24, 2020

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Alagic Franklin DMD PC

  • General Practice Dentistry
  • Concord, NC
  • NPI 1912698903
  NPD

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

{
    "created_epoch": "1587686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592352000000",
    "number": "1154941607",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11400 SPREADING OAK LN",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282263716",
            "telephone_number": "704-576-3192"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8815 CHRISTENBURY PKWY STE 40",
            "city": "CONCORD",
            "state": "NC",
            "postal_code": "280270261",
            "telephone_number": "704-264-0253"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "CHRISTOPHER",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-04-24",
        "last_updated": "2020-06-17",
        "certification_date": "2020-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NC",
            "license": "11854",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• CK41 Facilities Service
• Andrew Clark, PHARMD
• Brittney K Clark
• Camille Danielle Clark, BIRTH DOULA
• Catherine Clark
• Debra Clark, PNP
• Devin Clark, LCMHC-A, NCC
• Dion Crimson Clark, MS
• John Philip Clark, PHARMD
• Jymon Tirae Clark, PHARMD

• General Practice Dentistry in Concord, NC
• Providers in Concord, NC by specialty
• General Practice Dentistry in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2020; 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.