Robert S Clark, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

13190 Issued in MA

Practice address

31 Schoosett St
Suite 101
Pembroke, MA 02359

Phone

(781) 826-7577

Fax

(781) 826-8970

NPI assigned

Jul 24, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Robert S Clark DDS

  • General Practice Dentistry
  • Pembroke, MA
  • NPI 1306027529
  NPD (past) Authorized official
• Steven D. Spitz, DMD,LLC

  • Dentist
  • Pembroke, MA
  • NPI 1619218203
  NPD (past)

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

{
    "created_epoch": "1153699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1192665600000",
    "number": "1710909536",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31 SCHOOSETT ST",
            "address_2": "SUITE 101",
            "city": "PEMBROKE",
            "state": "MA",
            "postal_code": "02359",
            "telephone_number": "781-826-7577",
            "fax_number": "781-826-8970"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31 SCHOOSETT ST",
            "address_2": "SUITE 101",
            "city": "PEMBROKE",
            "state": "MA",
            "postal_code": "02359",
            "telephone_number": "781-826-7577",
            "fax_number": "781-826-8970"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "ROBERT",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-24",
        "last_updated": "2007-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MA",
            "license": "13190",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0248126",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Center for Behavioral Health,LLC
• Tammy Rocha Cetrino, LICSW
• Aniket Chakrabarti, M.D.
• Charm Medical Supply, Inc.
• Nan Chen, DMD
• Jennifer Cleary, MSW, LCSW
• Lauren Cleary
• Jessica Clement
• Tai Coburn
• Rachel S Cohen, LICSW

• General Practice Dentistry in Pembroke, MA
• Providers in Pembroke, MA by specialty
• General Practice Dentistry in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2007; 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.