Individual provider Active NPI

Wendy Auclair Clark, D.D.S.

  • Prosthodontics
  • Chapel Hill, NC
National Provider Identifier
1578884557
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
ProsthodonticsTaxonomy code 1223P0700X
License
10756 Issued in NC
Practice address
Dental Faculty Practice CB 7450
Chapel Hill, NC 27599-5994
Phone
(919) 537-3939
NPI assigned
Jun 14, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DN013626 GA
Prosthodontics 1223P0700X 10756 NC Primary

Addresses

Primary practice location

Dental Faculty Practice CB 7450
Chapel Hill, NC 27599-5994

Mailing address

343 Brauer Hall Unc School of Dentistry CB#7450
Chapel Hill, NC 27599-7450
Phone (919) 537-3437

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160725000454 GA Order and Referring Only - DentistPractitioner - Dentist 5193018455

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DN013626GAMDGeneral Practice Dentistry
10756NCMDProsthodontist

NPI Registry JSON

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

{
    "created_epoch": "1276473600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1578884557",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "343 BRAUER HALL UNC SCHOOL OF DENTISTRY CB#7450",
            "city": "CHAPEL HILL",
            "state": "NC",
            "postal_code": "275997450",
            "telephone_number": "919-537-3437"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "DENTAL FACULTY PRACTICE CB 7450",
            "city": "CHAPEL HILL",
            "state": "NC",
            "postal_code": "275995994",
            "telephone_number": "919-537-3939"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "WENDY",
        "middle_name": "AUCLAIR",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-06-14",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "GA",
            "license": "DN013626",
            "primary": false
        },
        {
            "code": "1223P0700X",
            "taxonomy_group": "",
            "desc": "Dentist, Prosthodontics",
            "state": "NC",
            "license": "10756",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chapel Hill, NC

Sources for this page

Verify at the official NPI Registry.