NPIMap

Organization Active NPI

Christopher Clark, DDS, II, PLLC

  • Dentist
  • Greensboro, NC
National Provider Identifier
1619638970
Registry record updated Jan 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
CHRISTOPHER CLARK, DDS, II, PLLC
Practice address
1037 Homeland Avenue
Greensboro, NC 27405
Phone
(336) 727-0132
Fax
(336) 272-3644
NPI assigned
Jan 7, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 7, 2022

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

Authorized official

Name
Dr. Christopher Clark
Title
President/Dentist
Phone
(336) 272-0132

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X Primary

Addresses

Primary practice location

1037 Homeland Avenue
Greensboro, NC 27405

Mailing address

1037 Homeland Avenue
Greensboro, NC 27405
Phone (336) 727-0132

Other names 1

  • Homeland Avenue Dentistry Doing business as

National Provider Directory

National Provider Directory

Locations

1037 Homeland Ave
Greensboro, NC 27405
Phone (336) 272-0132

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1641513600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1641513600000",
    "number": "1619638970",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1037 HOMELAND AVENUE",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "27405",
            "telephone_number": "336-727-0132",
            "fax_number": "336-272-3644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1037 HOMELAND AVENUE",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "27405",
            "telephone_number": "336-727-0132",
            "fax_number": "336-272-3644"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHRISTOPHER CLARK, DDS, II, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-01-07",
        "last_updated": "2022-01-07",
        "certification_date": "2022-01-07",
        "status": "A",
        "authorized_official_last_name": "CLARK",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_title_or_position": "PRESIDENT/DENTIST",
        "authorized_official_telephone_number": "336-272-0132",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Homeland Avenue Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Greensboro, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2022; 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.