Individual provider Active NPI

James M. Clark, DMD

  • General Practice Dentistry
  • Birmingham, AL
National Provider Identifier
1255409470
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
3834 Issued in AL
Practice address
100 Heatherbrooke Park Dr
Suite a
Birmingham, AL 35242-8093
Phone
(205) 991-9535
NPI assigned
Dec 4, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 3834 AL Primary

Addresses

Primary practice location

100 Heatherbrooke Park Dr
Suite a
Birmingham, AL 35242-8093

Mailing address

100 Heatherbrooke Park Dr
Suite a
Birmingham, AL 35242-8093
Phone (205) 991-9535

Other identifiers 1

IdentifierTypeStateIssuer
AL3834OtherALALA. DENTAL LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
3834ALMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Paige R. Lester, DDS, P.C. General Practice Past Accepting new patients
James M. Clark, DMD, P.C. General Practice Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1165190400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1255409470",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 HEATHERBROOKE PARK DR",
            "address_2": "SUITE A",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352428093",
            "telephone_number": "205-991-9535"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 HEATHERBROOKE PARK DR",
            "address_2": "SUITE A",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352428093",
            "telephone_number": "205-991-9535"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "JAMES",
        "middle_name": "M.",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-04",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AL",
            "license": "3834",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ALA. DENTAL LICENSE",
            "identifier": "AL3834",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Birmingham, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.