David Michael Clark, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

13431 Issued in MI

Practice address

29330 W 12 Mile Rd
Farmington Hills, MI 48334-4110

Phone

(248) 855-4850

Fax

(248) 855-5371

NPI assigned

Jul 18, 2006

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 MI

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.

• DRS. Clark & Romzick, PC

  • General Practice Dentistry
  • Farmington Hills, MI
  • NPI 1730168360
  NPD (past) Authorized official
• Radiant Dental, PLLC

  • Dental Clinic/Center
  • Farmington Hills, MI
  • NPI 1841976958
  NPD (past)

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

{
    "created_epoch": "1153180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1194744508",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29330 W 12 MILE RD",
            "city": "FARMINGTON HILLS",
            "state": "MI",
            "postal_code": "483344110",
            "telephone_number": "248-855-4850",
            "fax_number": "248-855-5371"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29330 W 12 MILE RD",
            "city": "FARMINGTON HILLS",
            "state": "MI",
            "postal_code": "483344110",
            "telephone_number": "248-855-4850",
            "fax_number": "248-855-5371"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "DAVID",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-18",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "13431",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Chloe Jehn Clark
• Christal Clark
• Christian Clark
• Christy Clark
• Dana Clark
• De'Asia Clark
• Deandria Clark
• Demi Clark
• Diamond Clark
• DJ Clark

• General Practice Dentistry in Farmington Hills, MI
• Providers in Farmington Hills, MI by specialty
• General Practice Dentistry in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.