Jessica M. Clark, DDS

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

04041414334 Issued in VA

Legal business name

JESSICA M. CLARK, DDS

Doing business as

Jessica M. Clark, DDS

Practice address

1300 Kempsville Rd Ste 5
Virginia Beach, VA 23464-6199

Phone

(757) 467-7797

NPI assigned

Nov 6, 2017

Organization subpart

Yes

Parent organization

ATLANTIC DENTAL CARE, PLCAs reported in NPPES

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

Authorized official

Name

Dr. Jessica Michelle Clark, DDS

Title

Pediatric Dentist

Phone

(757) 467-7797

Specialties & licenses 1

Addresses

Other names 1

• Jessica M. Clark, DDS Doing business as

Part of

Melvin E Cruser III DDS

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• Atlantic Dental Care, PLC

  • Dentist
  • Virginia Beach, VA
  • NPI 1831434711
  NPPES parent name

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

{
    "created_epoch": "1509926400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1509926400000",
    "number": "1235642828",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1300 KEMPSVILLE RD STE 5",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234646199",
            "telephone_number": "757-467-7797"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 KEMPSVILLE RD STE 5",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234646199",
            "telephone_number": "757-467-7797"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JESSICA M. CLARK, DDS",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ATLANTIC DENTAL CARE, PLC",
        "enumeration_date": "2017-11-06",
        "last_updated": "2017-11-06",
        "status": "A",
        "authorized_official_last_name": "CLARK",
        "authorized_official_first_name": "JESSICA",
        "authorized_official_middle_name": "MICHELLE",
        "authorized_official_title_or_position": "PEDIATRIC DENTIST",
        "authorized_official_telephone_number": "757-467-7797",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "VA",
            "license": "04041414334",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Jessica M. Clark, DDS",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jeremy B. Davidson DDS PC (Davidson Orthodontics)
• Jeremy Shulman
• Jerious Counseling Services, LLC
• Jerry G Caravas, DDS, PC
• Ashley S Jessen, PA-C
• Jessica M. Clark, DDS, P.C.
• Laquaysha Jessie
• Mallory Brooke Jester, COTA/L
• Jet Dental of Virginia PLLC
• Cheryl Lynn Jeter, FNP-C

• Pediatric Dentistry in Virginia Beach, VA
• Providers in Virginia Beach, VA by specialty
• Pediatric Dentistry in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2017; 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.