Clark Dentistry, Professional Corporation

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

32453 Issued in CA

Legal business name

CLARK DENTISTRY, PROFESSIONAL CORPORATION

Practice address

330 Park Ave
#10
Laguna Beach, CA 92651-2352

Phone

(949) 494-1445

Fax

(949) 494-1215

NPI assigned

Jun 12, 2007

Organization subpart

No

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

Authorized official

Name

Dr. William B Clark, DDSNPI 1194863555

Title

President

Phone

(949) 494-1445

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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

• William B Clark, DDS

  • General Practice Dentistry
  • Laguna Beach, CA
  • NPI 1194863555
  NPD (past) Authorized official

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

{
    "created_epoch": "1181606400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1275737405",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "330 PARK AVE",
            "address_2": "#10",
            "city": "LAGUNA BEACH",
            "state": "CA",
            "postal_code": "926512352",
            "telephone_number": "949-494-1445",
            "fax_number": "949-494-1215"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "330 PARK AVE",
            "address_2": "#10",
            "city": "LAGUNA BEACH",
            "state": "CA",
            "postal_code": "926512352",
            "telephone_number": "949-494-1445",
            "fax_number": "949-494-1215"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLARK DENTISTRY, PROFESSIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-12",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "CLARK",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "949-494-1445",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "32453",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Clint Robert Christie, M.A.
• Diane Christopherson, D.C.
• Trisha Church
• Brandon Cirbo
• City of Laguna Beach
• Rebecca Lynne Clark Mane, LMFT
• William B Clark, DDS
• Kassie Claughton, LCSW
• David N Cler, O.D.
• Kellee Rae Clougherty, M.D.

• General Practice Dentistry in Laguna Beach, CA
• Providers in Laguna Beach, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.