Active NPI
Robert Lauriston Clark, DDS
- Orthodontics and Dentofacial Orthopedics Dentistry
- La Porte, TX
National Provider Identifier
1346730702
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthodontics and Dentofacial Orthopedics Dentistry
- License
- 39262
- Practice address
- 9001 Spencer Hwy Ste J
La Porte, TX 77571-3897 - Phone
- (281) 394-0517
- NPI assigned
- May 11, 2018
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthodontics and Dentofacial Orthopedics Dentistry | 1223X0400X | 16781 | MD | |
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Orthodontics and Dentofacial Orthopedics Dentistry | 1223X0400X | 39262 | TX | Primary |
| Orthodontics and Dentofacial Orthopedics Dentistry | 1223X0400X | 061019 | NY |
Addresses
Primary practice location
9001 Spencer Hwy Ste J
La Porte, TX 77571-3897
Mailing address
3102 Dunkagle CT
Bowie, MD 20721-1261
Other practice location 1
22618 Aldine Westfield Rd
Spring, TX 77373-6569
Phone (832) 706-4930
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 39262 | TX | MD | Clinical Psychologist |
| 16781 | MD | MD | Orthodontics and Dentofacial Orthopedic Dentist |
| 061019 | NY | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1525996800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1718668800000",
"number": "1346730702",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3102 DUNKAGLE CT",
"city": "BOWIE",
"state": "MD",
"postal_code": "207211261"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9001 SPENCER HWY STE J",
"city": "LA PORTE",
"state": "TX",
"postal_code": "775713897",
"telephone_number": "281-394-0517"
}
],
"practiceLocations": [
{
"address_1": "22618 Aldine Westfield Rd",
"address_purpose": "LOCATION",
"city": "Spring",
"state": "TX",
"postal_code": "773736569",
"country_code": "US",
"telephone_number": "832-706-4930",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "CLARK",
"first_name": "ROBERT",
"middle_name": "LAURISTON",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-05-11",
"last_updated": "2024-06-18",
"certification_date": "2024-06-18",
"status": "A"
},
"taxonomies": [
{
"code": "1223X0400X",
"taxonomy_group": "",
"desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
"state": "MD",
"license": "16781",
"primary": false
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "1223X0400X",
"taxonomy_group": "",
"desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
"state": "TX",
"license": "39262",
"primary": true
},
{
"code": "1223X0400X",
"taxonomy_group": "",
"desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
"state": "NY",
"license": "061019",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in La Porte, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.