John W. Clark PA

Primary specialty

Customized Equipment (DME)Taxonomy code 332BC3200X

License

3365 Issued in ME

Legal business name

JOHN W. CLARK PA

Practice address

753 Stillwater Ave
Bangor, ME 04401-3633

Phone

(207) 990-5887

Fax

(207) 307-7002

NPI assigned

Oct 14, 2015

Organization subpart

No

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

Authorized official

Name

Dr. John W Clark, DDSNPI 1235344052

Title

President

Phone

(207) 564-8197

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in ME

Enrollment records 1

Locations

Practitioners 1

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

• John Warren Clark, DDS

  • Dentist
  • Dover Foxcroft, ME
  • NPI 1235344052
  NPD Authorized official

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

{
    "created_epoch": "1444780800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1736899200000",
    "number": "1275904435",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "753 STILLWATER AVE",
            "city": "BANGOR",
            "state": "ME",
            "postal_code": "044013633",
            "telephone_number": "207-990-5887",
            "fax_number": "207-564-8489"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "753 STILLWATER AVE",
            "city": "BANGOR",
            "state": "ME",
            "postal_code": "044013633",
            "telephone_number": "207-990-5887",
            "fax_number": "207-307-7002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOHN W. CLARK PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-10-14",
        "last_updated": "2025-01-15",
        "certification_date": "2025-01-15",
        "status": "A",
        "authorized_official_last_name": "CLARK",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "207-564-8197",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": "ME",
            "license": "3365",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• John a. Bradford M.D., P.a.
• John E. Tozer, DMD, PA
• John R. McGill, MD PA
• John R. McGill, MD, PA
• John Utterback
• John W. Clark PA
• Kadine Johns
• Anne Johnson, DPT
• Jessica L Johnson, PHARMD
• Liela Banks Johnson

• Customized Equipment (DME) in Bangor, ME
• Providers in Bangor, ME by specialty
• Customized Equipment (DME) in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.