NPIMap

Organization Active NPI

Christopher Clark, DDS & Associates, PA

  • Dentist
  • Raleigh, NC
National Provider Identifier
1346546314
Registry record updated Feb 8, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
7917 Issued in NC
Legal business name
CHRISTOPHER CLARK, DDS & ASSOCIATES, PA
Practice address
4558 Capital Blvd Ste B
Raleigh, NC 27604-4538
Phone
(910) 863-2377
Fax
(910) 863-2555
NPI assigned
Feb 8, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 8, 2011

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

Authorized official

Name
Dr. Christopher Clark, DDS
Title
Owner/Dentist
Phone
(910) 863-2377

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X 7917 NC Primary

Addresses

Primary practice location

4558 Capital Blvd Ste B
Raleigh, NC 27604-4538

Mailing address

4558 Capital Blvd Ste B
Raleigh, NC 27604-4538
Phone (910) 863-2377

Other names 1

  • Mini City Dental Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Christopher Clark DDS Associates PA2 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.

NPI Registry JSON

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

{
    "created_epoch": "1297123200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1297123200000",
    "number": "1346546314",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4558 CAPITAL BLVD STE B",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276044538",
            "telephone_number": "910-863-2377",
            "fax_number": "910-863-2555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4558 CAPITAL BLVD STE B",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276044538",
            "telephone_number": "910-863-2377",
            "fax_number": "910-863-2555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHRISTOPHER CLARK, DDS & ASSOCIATES, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-02-08",
        "last_updated": "2011-02-08",
        "status": "A",
        "authorized_official_last_name": "CLARK",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_title_or_position": "OWNER/DENTIST",
        "authorized_official_telephone_number": "910-863-2377",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "NC",
            "license": "7917",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mini City Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Raleigh, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2011; 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.