Dean W Clark, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

31763 Issued in CA

Practice address

2875 Middlefield Rd
Suite 4
Palo Alto, CA 94306-2554

Phone

(650) 326-5861

Fax

(650) 326-5826

NPI assigned

Dec 19, 2006

Sex

Male

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

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.

• Collins and Mingrone D.D.S., P.C.

  • Dentist
  • Palo Alto, CA
  • NPI 1922503960
  NPD (past)

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

{
    "created_epoch": "1166486400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1609939453",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2875 MIDDLEFIELD RD",
            "address_2": "SUITE 4",
            "city": "PALO ALTO",
            "state": "CA",
            "postal_code": "943062554",
            "telephone_number": "650-326-5861",
            "fax_number": "650-326-5826"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2875 MIDDLEFIELD RD",
            "address_2": "SUITE 4",
            "city": "PALO ALTO",
            "state": "CA",
            "postal_code": "943062554",
            "telephone_number": "650-326-5861",
            "fax_number": "650-326-5826"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "DEAN",
        "middle_name": "W",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "31763",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Robin Malone Cisco, M.D.
• Lesly Emili Cisneros Avina
• City of Palo Alto
• Cody William Civiletto, MD
• David J Clark, MD/PHD
• Jeffry Russell Clark, MFC
• Katherine Clark, CPNP
• Kelsey Allison Clark, PHD
• Kevin Lewis Clark, MSW
• Mary Clark, AU.D.

• General Practice Dentistry in Palo Alto, CA
• Providers in Palo Alto, 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 Jul 8, 2007; 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.