NPIMap

Individual provider Active NPI

Donald Clarke, D.D.S.

  • General Practice Dentistry
  • Folsom, CA
National Provider Identifier
1750615910
Registry record updated Nov 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
33738 Issued in CA
Practice address
25005 Blue Ravine Rd Ste 100
Folsom, CA 95630-5706
Phone
(916) 984-8050
NPI assigned
Sep 21, 2009
Last updated
Nov 8, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 8, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 33738 CA Primary

Addresses

Primary practice location

25005 Blue Ravine Rd Ste 100
Folsom, CA 95630-5706

Mailing address

3901 Marconi Ave
Sacramento, CA 95821-3902
Phone (916) 487-0117

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Donald E. Clarke, D.D.S., Inc. CurrentSince Mar 20, 2022 Accepting new patients
Mantena Dental Corportation General Practice CurrentSince Nov 16, 2021 Accepting new patients
Donald E. Clarke, D.D.S., Inc. Past Accepting new patients
Donald E. Clarke, D.D.S., Inc. Past Accepting new patients

Locations

25005 Blue Ravine Rd
Ste 100
Folsom, CA 95630
Phone (916) 600-3719

3901 Marconi Ave
Sacramento, CA 95821
Phone (916) 487-7995

Organizations & group practices 9

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

NPI Registry JSON

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

{
    "created_epoch": "1253491200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636329600000",
    "number": "1750615910",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3901 MARCONI AVE",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958213902",
            "telephone_number": "916-487-0117"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25005 BLUE RAVINE RD STE 100",
            "city": "FOLSOM",
            "state": "CA",
            "postal_code": "956305706",
            "telephone_number": "916-984-8050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARKE",
        "first_name": "DONALD",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-09-21",
        "last_updated": "2021-11-08",
        "certification_date": "2021-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "33738",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Folsom, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2021; 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.