Sarah Grace Clark, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

4384 Issued in AR

Practice address

2425 Prince St Ste 1
Conway, AR 72034-3701

Phone

(903) 486-2808

NPI assigned

Nov 17, 2019

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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

• Sarah G. Clark, D.D.S., PLLC

  dba Southern Smiles Family Dentistry

  • Dental Clinic/Center
  • Conway, AR
  • NPI 1902445778
  NPD Authorized official

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

{
    "created_epoch": "1573948800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1577923200000",
    "number": "1558906248",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2545 GRUMMER LN",
            "city": "CONWAY",
            "state": "AR",
            "postal_code": "720342012"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2425 PRINCE ST STE 1",
            "city": "CONWAY",
            "state": "AR",
            "postal_code": "720343701",
            "telephone_number": "903-486-2808"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "SARAH",
        "middle_name": "GRACE",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-11-17",
        "last_updated": "2020-01-02",
        "certification_date": "2020-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AR",
            "license": "4384",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kelly L Clark, PTA
• Leslea Clark, M.S.CCC-SLP
• Madelyn Clark
• Mark L Clark, PHD
• Raymond H Clark, MD
• Candace Marie Clarke-Brown, AT
• Celeste A Clarke, DC
• Chantillee A Clary
• Daxton Clatworthy
• Jody Shawn Clawson, A.P.N.

• General Practice Dentistry in Conway, AR
• Providers in Conway, AR by specialty
• General Practice Dentistry in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2020; 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.