Elizabeth Ann Clark, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

30 020404 Issued in OH

Practice address

135 Rue Maiseille Dr.
Dayton, OH 45429

Phone

(937) 902-6233

NPI assigned

Apr 17, 2007

Last updated

Mar 24, 2015By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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": "1176768000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1427155200000",
    "number": "1194941351",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "135 RUE MAISEILLE DR.",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "45429",
            "telephone_number": "937-902-6233"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "135 RUE MAISEILLE DR.",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "45429",
            "telephone_number": "937-902-6233"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "ELIZABETH",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-17",
        "last_updated": "2015-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OH",
            "license": "30 020404",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OH",
            "license": "30020404",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cherie Lynn Clark, NP
• Darcie Rupert Clark, MS, LPCC, LCDCIII
• David E. Clark, R.D.
• Demetrius Rashaun Clark
• Donald Lester Clark, MD
• Ellen Yvette Clark
• Emily E. Clark, NNP
• Emma Caroline Clark
• Jenna Marie Clark, NNP
• Jennifer Lisa Clark, CDCA

• Dentist in Dayton, OH
• Providers in Dayton, OH by specialty
• Dentist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2015; 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.