Clear Creek Dentistry, PLLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

27909 Issued in TX

Legal business name

CLEAR CREEK DENTISTRY, PLLC

Practice address

901 Normal Park Dr Ste 202
Huntsville, TX 77320-3770

Phone

(617) 319-6674

NPI assigned

Jan 27, 2016

Last updated

Jul 5, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Jeffrey Clark, D.M.D.NPI 1003100934

Title

Owner

Phone

(936) 291-0032

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Jeffrey Paul Clark, D.M.D.

  • General Practice Dentistry
  • Conroe, TX
  • NPI 1003100934
  NPD Authorized official

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

{
    "created_epoch": "1453852800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1467676800000",
    "number": "1659738276",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5430 PINE SPRINGS CT",
            "city": "CONROE",
            "state": "TX",
            "postal_code": "773044052"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 NORMAL PARK DR STE 202",
            "city": "HUNTSVILLE",
            "state": "TX",
            "postal_code": "773203770",
            "telephone_number": "617-319-6674"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLEAR CREEK DENTISTRY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-01-27",
        "last_updated": "2016-07-05",
        "status": "A",
        "authorized_official_last_name": "CLARK",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "936-291-0032",
        "authorized_official_credential": "D.M.D."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "27909",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amaka Chinedo
• Christopher J. Wright, MD, PA
• Sandra Clapp, NP-C
• Carly Morgan Clark
• Jordan Scott Clark
• Mervin Leigh Cleveland Jr., LPC
• Pershelle Lashun Cleveland, RN
• CLP Regency of Texas, LLC (Hospice Compassus - Houston)
• Coastal Access Inc
• Amanda Marie Coffey

• General Practice Dentistry in Huntsville, TX
• Providers in Huntsville, TX by specialty
• General Practice Dentistry in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 5, 2016; 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.