Clark Hamilton III

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

DS043808 Issued in PA

Practice address

2010 S Juniper St
Philadelphia, PA 19148-5509

Phone

(215) 334-3490

NPI assigned

Apr 6, 2022

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)

Not enrolled

State licenses

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

{
    "created_epoch": "1649203200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727049600000",
    "number": "1174264758",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "413 HILLSIDE AVE",
            "city": "JENKINTOWN",
            "state": "PA",
            "postal_code": "190462116",
            "telephone_number": "215-806-5282"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2010 S JUNIPER ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191485509",
            "telephone_number": "215-334-3490"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "805 Route 38",
            "address_purpose": "LOCATION",
            "city": "Cherry Hill",
            "state": "NJ",
            "postal_code": "080022850",
            "country_code": "US",
            "telephone_number": "215-282-8000 x5120",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HAMILTON",
        "first_name": "CLARK",
        "name_suffix": "III",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-04-06",
        "last_updated": "2024-09-23",
        "certification_date": "2024-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "PA",
            "license": "DS043808",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Abigail S Hamilton, PSY.D
• Adele Hamilton, CRNP
• Callum Hamilton
• Charlotte Hamilton, CRNP
• Christopher Todd Hamilton
• Emily Katherine Wunsch Hamilton, NP
• Justine Hamilton, MD
• Keith W Hamilton, MD
• Latisa Marie Hamilton, MS
• Michael Gbenga Hamilton, MB;BS

• Pediatric Dentistry in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Pediatric Dentistry in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2024; 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.