Kristin D. Clark DDS, Ms, PA

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

Legal business name

KRISTIN D. CLARK DDS, MS, PA

Doing business as

Clark Orthodontics

Practice address

5503 John F. Kennedy Blvd.
North Little Rock, AR 72116

Phone

(501) 758-4112

Fax

(501) 758-4117

NPI assigned

Nov 6, 2013

Last updated

Sep 13, 2022By 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

Kristin D Clark, DDS, MS, PANPI 1336466283

Title

Doctor/Owner

Phone

(501) 758-4112

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Clark Orthodontics Doing business as

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.

• Kristin Dumboski Clark, DDS, MS

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • North Little Rock, AR
  • NPI 1336466283
  NPD Authorized official

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

{
    "created_epoch": "1383696000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1663027200000",
    "number": "1700215175",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5503 JOHN F. KENNEDY BLVD.",
            "city": "NORTH LITTLE ROCK",
            "state": "AR",
            "postal_code": "72116",
            "telephone_number": "501-758-4112",
            "fax_number": "501-758-4117"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5503 JOHN F. KENNEDY BLVD.",
            "city": "NORTH LITTLE ROCK",
            "state": "AR",
            "postal_code": "72116",
            "telephone_number": "501-758-4112",
            "fax_number": "501-758-4117"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KRISTIN D. CLARK DDS, MS, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-11-06",
        "last_updated": "2022-09-13",
        "certification_date": "2022-09-13",
        "status": "A",
        "authorized_official_last_name": "CLARK",
        "authorized_official_first_name": "KRISTIN",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "DOCTOR/OWNER",
        "authorized_official_telephone_number": "501-758-4112",
        "authorized_official_credential": "DDS, MS, PA"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200527631",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Clark Orthodontics",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Clark Orthodontics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Erica Louise Kosmach, B.S., MHPP
• Vinisha Reddy Kota, M.D.
• Sujit Kumar Kotapati, M.D
• Atul Kothari, MD
• Monica Kothari, MD
• Kroger Limited Partnership I (Kroger Pharmacy)
• Kroger Limited Partnership I (Kroger Pharmacy)
• Santoshi Krupanagaram
• Eugene John Kuc, M.D.
• Alexys A Kuchinski, LCSW

• Orthodontics and Dentofacial Orthopedics Dentistry in North Little Rock, AR
• Providers in North Little Rock, AR by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2022; 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.