Janice D Clark, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

8703 Issued in NC

Practice address

2041 Silas Creek Pkwy
Winston Salem, NC 27103-5147

Phone

(336) 777-1272

Fax

(336) 777-1196

NPI assigned

Oct 28, 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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1225152000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1225152000000",
    "number": "1639322233",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2211 EXECUTIVE ST",
            "address_2": "SUITE E",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282083661",
            "telephone_number": "704-395-6000",
            "fax_number": "704-398-7373"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2041 SILAS CREEK PKWY",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271035147",
            "telephone_number": "336-777-1272",
            "fax_number": "336-777-1196"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "JANICE",
        "middle_name": "D",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-10-28",
        "last_updated": "2008-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NC",
            "license": "8703",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Denise Ray Clark, CRNA
• Elspeth Clark, D.O.
• Heather Lynn Clark, MD, PHD
• Heather Marie Nettles Clark, M.D.
• Jakayla Clark
• Jeniece Clark
• Jerry Randall Clark, MD
• Karrie Shaffer Clark
• Kay Freeman Clark, MSW
• Kristen McKinney Clark

• General Practice Dentistry in Winston Salem, NC
• Providers in Winston Salem, NC by specialty
• General Practice Dentistry in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2008; 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.