Individual provider Active NPI

Lindsey Marie Clark-Fass, D.D.S.

  • General Practice Dentistry
  • Ennis, TX
National Provider Identifier
1649433640
Registry record updated Aug 11, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
23949 Issued in TX
Practice address
2409 Yorkstown Dr
Ennis, TX 75119-2191
Phone
(972) 875-3400
Fax
(972) 875-4020
NPI assigned
Jul 9, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 23949 TX Primary

Addresses

Primary practice location

2409 Yorkstown Dr
Ennis, TX 75119-2191

Mailing address

2409 Yorkstown Dr.
Ennis, TX 75119
Phone (972) 875-3400

Other names 1

  • Dr. Lindsey Marie Clark Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
23949TXMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Larry W. Treadaway, D.D.S., Inc. General Practice Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1215561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1786406400000",
    "number": "1649433640",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2409 YORKSTOWN DR.",
            "city": "ENNIS",
            "state": "TX",
            "postal_code": "75119",
            "telephone_number": "972-875-3400",
            "fax_number": "972-875-4020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2409 YORKSTOWN DR",
            "city": "ENNIS",
            "state": "TX",
            "postal_code": "751192191",
            "telephone_number": "972-875-3400",
            "fax_number": "972-875-4020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK-FASS",
        "first_name": "LINDSEY",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-07-09",
        "last_updated": "2026-08-11",
        "certification_date": "2026-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "23949",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LINDSEY",
            "last_name": "CLARK",
            "middle_name": "MARIE",
            "prefix": "DR.",
            "credential": "D.D.S.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Ennis, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2026; 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.