Shelly K. Clark D.D.S., P.a.

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

Legal business name

SHELLY K. CLARK D.D.S., P.A.

Practice address

211 W Belt Line Rd
South Suite
Cedar Hill, TX 75104-2066

Phone

(972) 291-0111

NPI assigned

Oct 4, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Shelly K. Clark, D.D.S.

Title

President/ Ceo

Phone

(972) 291-0111

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1159920000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1669567772",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "211 W BELT LINE RD",
            "address_2": "SOUTH SUITE",
            "city": "CEDAR HILL",
            "state": "TX",
            "postal_code": "751042066",
            "telephone_number": "972-291-0111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "211 W BELT LINE RD",
            "address_2": "SOUTH SUITE",
            "city": "CEDAR HILL",
            "state": "TX",
            "postal_code": "751042066",
            "telephone_number": "972-291-0111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHELLY K. CLARK D.D.S., P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-04",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "CLARK",
        "authorized_official_first_name": "SHELLY",
        "authorized_official_middle_name": "K.",
        "authorized_official_title_or_position": "PRESIDENT/ CEO",
        "authorized_official_telephone_number": "972-291-0111",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Donna Arlene Shannon, M.D.
• Share Wellness Medical Clinic PLLC
• Kyra Shaw, DPT, ATC
• Paul V Shelburne, MD
• Shelly K. Clark
• Imisha Nikole Shelton
• Sheri Ekukpe D.C.P.a.
• Sherry L. Bowers, DPM, PA
• Shining Star Residential Facility, LLC.
• Shiny Days Health Care, LLC

• Pediatric Dentistry in Cedar Hill, TX
• Providers in Cedar Hill, TX by specialty
• Pediatric Dentistry in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.