Healthy Smiles Family & Cosmetic Dentistry PSC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

8481 Issued in KY

Legal business name

HEALTHY SMILES FAMILY & COSMETIC DENTISTRY PSC

Practice address

83 Oak Ridge CT
Prestonsburg, KY 41653-8595

Phone

(606) 886-0300

Fax

(606) 886-9334

NPI assigned

Feb 6, 2013

Last updated

Feb 6, 2013By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Misty Dawn Clark, DMDNPI 1780870196

Title

Dentist

Phone

(606) 886-0300

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Misty Dawn Clark, D.M.D.

  • Dentist
  • Prestonsburg, KY
  • NPI 1780870196
  NPD (past) Authorized official

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

{
    "created_epoch": "1360108800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1360108800000",
    "number": "1194064493",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "83 OAK RIDGE CT",
            "city": "PRESTONSBURG",
            "state": "KY",
            "postal_code": "416538595",
            "telephone_number": "606-886-0300",
            "fax_number": "606-886-9334"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "83 OAK RIDGE CT",
            "city": "PRESTONSBURG",
            "state": "KY",
            "postal_code": "416538595",
            "telephone_number": "606-886-0300",
            "fax_number": "606-886-9334"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEALTHY SMILES FAMILY & COSMETIC DENTISTRY PSC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-02-06",
        "last_updated": "2013-02-06",
        "status": "A",
        "authorized_official_last_name": "CLARK",
        "authorized_official_first_name": "MISTY",
        "authorized_official_middle_name": "DAWN",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "606-886-0300",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "KY",
            "license": "8481",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100088720",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Dorothy Hazelette
• Jerry Hazlett
• Cheryl A Headen, LPCC
• Shalynn Healey, PERSP
• Healthy Heart Sleep Program
• Shawn Heaster
• Rhonda Heath
• Joseph Hedge
• Tara Hedge
• Catherine Hedges

• General Practice Dentistry in Prestonsburg, KY
• Providers in Prestonsburg, KY by specialty
• General Practice Dentistry in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2013; 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.