Ashley Nicole Clark, DDS

Primary specialty

Oral and Maxillofacial Pathology DentistryTaxonomy code 1223P0106X

License

12011677A Issued in IN

Practice address

9292 N Meridian St Ste 210
Indianapolis, IN 46260-1828

Phone

(317) 843-2204

NPI assigned

Jul 11, 2011

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in IN

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

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: aclark14884@ukhcdirect.org

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.

• Cutaneous and Maxillofacial Pathology Laboratory, PC

  • Clinical Medical Laboratory
  • Indianapolis, IN
  • NPI 1386717940
  Medicare reassignment NPD

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

{
    "created_epoch": "1310342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681257600000",
    "number": "1215225305",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9292 N MERIDIAN ST STE 210",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462601828",
            "telephone_number": "317-843-2204",
            "fax_number": "317-843-2478"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9292 N MERIDIAN ST STE 210",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462601828",
            "telephone_number": "317-843-2204"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "UK College of Dentistry",
            "address_2": "800 Rose ST",
            "address_purpose": "LOCATION",
            "city": "Lexington",
            "state": "KY",
            "postal_code": "40536",
            "country_code": "US",
            "telephone_number": "859-323-5515",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CLARK",
        "first_name": "ASHLEY",
        "middle_name": "NICOLE",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-07-11",
        "last_updated": "2023-04-12",
        "certification_date": "2023-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "KY",
            "license": "10417",
            "primary": false
        },
        {
            "code": "1223P0106X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Pathology",
            "state": "KY",
            "license": "10417",
            "primary": false
        },
        {
            "code": "1223P0106X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Pathology",
            "state": "IN",
            "license": "12011677A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Andreous Clark
• Anna Marie Clark, RN
• Anne C Clark, M.D.
• Anne Campbell Clark, DDS
• Anne Kowatsch Clark, MD
• Austin Clark
• Barbara Kay Clark, OTR
• Bradley A Clark, D.O.
• Brandon Clark
• Brandon Clark, NP

• Oral and Maxillofacial Pathology Dentistry in Indianapolis, IN
• Providers in Indianapolis, IN by specialty
• Oral and Maxillofacial Pathology Dentistry in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2023; 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.