Clark Dental Group PLLC

Primary specialty

DentistTaxonomy code 122300000X

Legal business name

CLARK DENTAL GROUP PLLC

Practice address

9844 S 1300 E Ste 360
Sandy, UT 84094-4698

Phone

(801) 571-6999

Fax

(801) 576-7507

NPI assigned

Feb 15, 2020

Last updated

Feb 15, 2020By 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

Dr. Tanner M Clark, DMDNPI 1679841811

Title

Dentist/Owner

Phone

(208) 317-8555

Specialties & licenses 1

Addresses

Locations

Practitioners 2

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.

• Tanner Mark Clark, D.M.D.

  • General Practice Dentistry
  • Philadelphia, PA
  • NPI 1679841811
  NPD (past) Authorized official
• Kimel Pierce Fisher, D.M.D.

  • Dentist
  • Sandy, UT
  • NPI 1831286152
  NPD (past)

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

{
    "created_epoch": "1581724800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1581724800000",
    "number": "1669005955",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10597 S BEACH COMBER WAY",
            "city": "SOUTH JORDAN",
            "state": "UT",
            "postal_code": "840096132",
            "telephone_number": "484-278-1169"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9844 S 1300 E STE 360",
            "city": "SANDY",
            "state": "UT",
            "postal_code": "840944698",
            "telephone_number": "801-571-6999",
            "fax_number": "801-576-7507"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLARK DENTAL GROUP PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-02-15",
        "last_updated": "2020-02-15",
        "certification_date": "2020-02-15",
        "status": "A",
        "authorized_official_last_name": "CLARK",
        "authorized_official_first_name": "TANNER",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "DENTIST/OWNER",
        "authorized_official_telephone_number": "208-317-8555",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Matthew Christopher, PA-C
• Lani Chun, D.D.S., M.S.D.
• Todd Chynoweth, R.P.T.
• William John Cimikoski Jr., M.D.
• Claritas Vision Care P.C. (Eye Care Solutions)
• Bryan A Clark, PA-C
• Desiree Deon Clark, PA-C
• Gary K. Clark, DMD
• Kathleen Pauline Clark, MA, BCBA, LBA
• Stanley Corbin Clark, MD

• Dentist in Sandy, UT
• Providers in Sandy, UT by specialty
• Dentist in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2020; 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.