Heather Elise Clark, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

2007014394 Issued in MO

Practice address

1331 Village Dr
Saint Joseph, MO 64506-2457

Phone

(816) 232-1444

NPI assigned

May 10, 2008

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

Enrolled in MO

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

Medicare enrollment (NPD)

Enrolled

Practice roles

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.

• Clark Family Dentistry

  • General Practice Dentistry
  • Saint Joseph, MO
  • NPI 1053568477
  NPD (past) Authorized official

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

{
    "created_epoch": "1210377600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1456185600000",
    "number": "1609043587",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1331 VILLAGE DR",
            "city": "SAINT JOSEPH",
            "state": "MO",
            "postal_code": "645062457",
            "telephone_number": "816-232-1444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1331 VILLAGE DR",
            "city": "SAINT JOSEPH",
            "state": "MO",
            "postal_code": "645062457",
            "telephone_number": "816-232-1444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "HEATHER",
        "middle_name": "ELISE",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-05-10",
        "last_updated": "2016-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MO",
            "license": "2007014394",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jacob Charles Christian, DO
• Douglas Chyatte, M.D.
• City of St. Joseph
• Clark Family Dentistry
• Alexavier Maximus Clark
• Robert C Clark, M.D.
• Vickie J Clark, MSW PLCSW
• Tennyson Clary, LMSW, CADC, SQP
• Timothy Pat Clary, PA-C
• Conlyn Taylor Clay

• General Practice Dentistry in Saint Joseph, MO
• Providers in Saint Joseph, MO by specialty
• General Practice Dentistry in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2016; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.