Clark Dental Studio, PLLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

9483 Issued in TN

Legal business name

CLARK DENTAL STUDIO, PLLC

Practice address

951 Riverfront Pkwy
#303
Chattanooga, TN 37402-2185

Phone

(423) 266-7927

NPI assigned

May 20, 2016

Organization subpart

No

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

Authorized official

Name

Dr. Matthew Clark, DDSNPI 1215290127

Title

Dentist/Owner

Phone

(731) 431-5613

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.

• Matthew L Clark, D.D.S.

  • Dentist
  • Dyersburg, TN
  • NPI 1215290127
  NPD (past) Authorized official

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

{
    "created_epoch": "1463702400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1463702400000",
    "number": "1336596196",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "951 RIVERFRONT PKWY",
            "address_2": "#303",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374022185"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "951 RIVERFRONT PKWY",
            "address_2": "#303",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374022185",
            "telephone_number": "423-266-7927"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLARK DENTAL STUDIO, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-05-20",
        "last_updated": "2016-05-20",
        "status": "A",
        "authorized_official_last_name": "CLARK",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_title_or_position": "DENTIST/OWNER",
        "authorized_official_telephone_number": "731-431-5613",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "TN",
            "license": "9483",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rebecca Joyce Cicha, PH.D.
• Renee Cimpanu, MD
• Brandon A Cincere, M.D.
• Nicholas Joseph Circolone, DC
• Colin Riley Clanton, MD
• Alexis Haven Clark
• Austin Frank Clark, MD
• Blanche W Clark
• Charlotte Anne Clark, SLP-CCC
• Christine Clark

• General Practice Dentistry in Chattanooga, TN
• Providers in Chattanooga, TN by specialty
• General Practice Dentistry in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2016; 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.