Stephen W Clark, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

20995 Issued in CA

Practice address

5963 E Spring St
Long Beach, CA 90808-3752

Phone

(562) 421-8401

Fax

(562) 421-0523

NPI assigned

Dec 12, 2006

Last updated

Sep 18, 2019By 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 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Stephen W. Clark, DDS Inc.

  dba Spring Dental Group

  • General Practice Dentistry
  • Long Beach, CA
  • NPI 1316301500

  Endodontics

  NPD (past) Authorized official
• Brock Lorenz Dental Corporation

  • Dental Clinic/Center
  • Long Beach, CA
  • NPI 1871217349
  NPD (past)

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

{
    "created_epoch": "1165881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568764800000",
    "number": "1447311725",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5963 E SPRING ST",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908083752",
            "telephone_number": "562-421-8401",
            "fax_number": "562-421-0523"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5963 E SPRING ST",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908083752",
            "telephone_number": "562-421-8401",
            "fax_number": "562-421-0523"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "STEPHEN",
        "middle_name": "W",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-12",
        "last_updated": "2019-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "CA",
            "license": "20995",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "20995",
            "primary": true
        },
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "CA",
            "license": "20995",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Keyon Clark
• Kristin Tai Clark
• Melissa Ann Clark, MCD, CCC-SLP
• Robert Alexander Clark, M.D
• Sheila Renee Clark, CATC
• Teresa Louise Clark, LVN
• Tiffany Clark
• Tracy Ann Clark, M.D.
• Matthew E.a. Clarke, MD
• Vanessa Nicole Claros, NP

• General Practice Dentistry in Long Beach, CA
• Providers in Long Beach, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2019; 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.