NPIMap

Organization Active NPI

Dennis P. Clark, D.M.D., P.C.

  • Oral and Maxillofacial Surgery (Dentist)
  • Tigard, OR
National Provider Identifier
1235249160
Registry record updated Apr 1, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
D7829 Issued in OR
Legal business name
DENNIS P. CLARK, D.M.D., P.C.
Practice address
9430 SW Coral St
Suite 200
Tigard, OR 97223-6691
Phone
(503) 245-1100
Fax
(503) 473-8300
NPI assigned
Aug 30, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2015

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

Authorized official

Name
Dr. Dennis P Clark, DMDNPI 1386868370
Title
President
Phone
(503) 245-1100

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist)Group: 193400000X SINGLE SPECIALTY GROUP 1223S0112X D7829 OR Primary

Addresses

Primary practice location

9430 SW Coral St
Suite 200
Tigard, OR 97223-6691

Mailing address

9430 SW Coral St
Suite 200
Tigard, OR 97223-6691
Phone (503) 245-1100

National Provider Directory

National Provider Directory

Locations

9430 SW Coral St
Ste 200
Tigard, OR 97223
Phone (503) 245-1100

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1427846400000",
    "number": "1235249160",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9430 SW CORAL ST",
            "address_2": "SUITE 200",
            "city": "TIGARD",
            "state": "OR",
            "postal_code": "972236691",
            "telephone_number": "503-245-1100",
            "fax_number": "503-473-8300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9430 SW CORAL ST",
            "address_2": "SUITE 200",
            "city": "TIGARD",
            "state": "OR",
            "postal_code": "972236691",
            "telephone_number": "503-245-1100",
            "fax_number": "503-473-8300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DENNIS P. CLARK, D.M.D., P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-30",
        "last_updated": "2015-04-01",
        "status": "A",
        "authorized_official_last_name": "CLARK",
        "authorized_official_first_name": "DENNIS",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "503-245-1100",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "OR",
            "license": "D7829",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tigard, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 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.