Stephen Chris Clark, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

OK 4100 Issued in OK

Practice address

7200 S Pennsylvania Ave
Suite B
Oklahoma City, OK 73159-3336

Phone

(405) 681-6668

Fax

(405) 682-6609

NPI assigned

Jun 12, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Chris Clark Other name

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1150070400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1433289600000",
    "number": "1699717769",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7200 S PENNSYLVANIA AVE",
            "address_2": "SUITE B",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731593336",
            "telephone_number": "405-681-6668",
            "fax_number": "405-682-6609"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7200 S PENNSYLVANIA AVE",
            "address_2": "SUITE B",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731593336",
            "telephone_number": "405-681-6668",
            "fax_number": "405-682-6609"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "STEPHEN",
        "middle_name": "CHRIS",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-12",
        "last_updated": "2015-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OK",
            "license": "OK 4100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CHRIS",
            "last_name": "CLARK",
            "credential": "D.D.S.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Robert Kenneth Clark, M.D.
• Robert Mel Clark, MD
• Ryan Alexander Clark, LAT, ATC
• Shawn David Clark, B.A.
• Shelby Clark
• Sue Ann Clark
• Tamara K Clark
• Tanashia Clark
• Terri Clark
• Thomas Bradley Clark, M.D.

• General Practice Dentistry in Oklahoma City, OK
• Providers in Oklahoma City, OK by specialty
• General Practice Dentistry in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.