Lana Johnson Clarke, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

313000 Issued in MS

Practice address

6142 US Hwy 98
Ste 10
Hattiesburg, MS 39402-8530

Phone

(601) 450-1123

Fax

(601) 450-1127

NPI assigned

Dec 13, 2006

Sex

Female

Sole proprietor

No

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

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Feb 28, 2016 through Feb 29, 2028

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1165968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1578624359",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6142 US HWY 98",
            "address_2": "STE 10",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "394028530",
            "telephone_number": "601-450-1123",
            "fax_number": "601-450-1127"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6142 US HWY 98",
            "address_2": "STE 10",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "394028530",
            "telephone_number": "601-450-1123",
            "fax_number": "601-450-1127"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARKE",
        "first_name": "LANA",
        "middle_name": "JOHNSON",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MS",
            "license": "313000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Misti Clark, PHARM.D.
• Nadia Shanise Clark, FNP-C
• Richard C Clark III, MDCAC
• Samantha Clark, PHARM D
• Kenita Clarke
• Lisa Clary, CPSS
• Richard Elwood Clatterbuck, M.D.
• Yvette Antionette Claverie, LCSW
• Ilyssa Claxton, CCSS
• Taylor Autrey Clayton, M.S., CF-SLP

• General Practice Dentistry in Hattiesburg, MS
• Providers in Hattiesburg, MS by specialty
• General Practice Dentistry in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.