James A Clark, DMD,MS

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

389 Issued in AK

Practice address

3650 Lake Otis Pkwy
Suite 201
Anchorage, AK 99508-5207

Phone

(907) 561-1430

Fax

(907) 561-2697

NPI assigned

Jul 28, 2006

Last updated

Jul 9, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

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

{
    "created_epoch": "1154044800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1376557736",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3650 LAKE OTIS PKWY",
            "address_2": "SUITE 201",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995085207",
            "telephone_number": "907-561-1430",
            "fax_number": "907-561-2697"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3650 LAKE OTIS PKWY",
            "address_2": "SUITE 201",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995085207",
            "telephone_number": "907-561-1430",
            "fax_number": "907-561-2697"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "JAMES",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "DMD,MS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-28",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "AK",
            "license": "389",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "DD0389",
            "state": "AK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRI-CARE ID",
            "identifier": "831476",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Andrea May Clark, MD
• Anton Victor Clark, PA-C
• Christine D Clark, MD
• Cynthia Clark
• Deanna Clark, MS,CCC-SLP
• Jessica Lynn Clark, RN
• John M Clark, MD
• Joshua Cade Clark, DMD
• Kerry A Clark, OT
• Kylie Clark

• Oral and Maxillofacial Surgery (Dentist) in Anchorage, AK
• Providers in Anchorage, AK by specialty
• Oral and Maxillofacial Surgery (Dentist) in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.