Dr Herald R Clark

Primary specialty

DentistTaxonomy code 122300000X

Legal business name

DR HERALD R CLARK

Practice address

2036 S 1300 E
Suite B
Salt Lake City, UT 84105-3601

Phone

(801) 486-9434

Fax

(801) 426-9444

NPI assigned

Apr 16, 2007

Last updated

Jul 16, 2013By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Herald R Clark, DDS PCNPI 1568855377

Title

Dentist

Phone

(801) 486-9434

Specialties & licenses 1

Addresses

Tax ID family

Dr Herald R Clark2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Herald R. Clark, DDS

  • Dentist
  • Salt Lake City, UT
  • NPI 1487086617
  NPD tax ID

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Herald Ruth Clark, DDS,PC

  • Dentist
  • Salt Lake City, UT
  • NPI 1568855377
  Authorized official Same address or phone

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

{
    "created_epoch": "1176681600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1373932800000",
    "number": "1306061270",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2036 S 1300 E",
            "address_2": "SUITE B",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841053601",
            "telephone_number": "801-486-9434",
            "fax_number": "801-426-9444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2036 S 1300 E",
            "address_2": "SUITE B",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841053601",
            "telephone_number": "801-486-9434",
            "fax_number": "801-426-9444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR HERALD R CLARK",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-16",
        "last_updated": "2013-07-16",
        "status": "A",
        "authorized_official_last_name": "CLARK",
        "authorized_official_first_name": "HERALD",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "801-486-9434",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS  PC"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "UT",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Dentist in Salt Lake City, UT
• Providers in Salt Lake City, UT by specialty
• Dentist in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2013; 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.