Caitlin M Clark

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

30.026171 Issued in OH

Practice address

3974 Karl Rd
Columbus, OH 43224-5221

Phone

(614) 267-5000

NPI assigned

Jun 8, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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.

• Equitas Health,Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Columbus, OH
  • NPI 1518227453
  NPD (past)
• German Village Dental Group, L.L.C.

  • General Practice Dentistry
  • Columbus, OH
  • NPI 1841408135
  NPD (past)
• Laury J Dimichaelangelo DDS Inc

  • Dentist
  • Columbus, OH
  • NPI 1295713915
  NPD (past)

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

{
    "created_epoch": "1591574400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1637884800000",
    "number": "1770107567",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1250 FLAGSTONE SQ",
            "city": "WESTERVILLE",
            "state": "OH",
            "postal_code": "430814574",
            "telephone_number": "419-234-8424"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3974 KARL RD",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432245221",
            "telephone_number": "614-267-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "CAITLIN",
        "middle_name": "M",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-06-08",
        "last_updated": "2021-11-26",
        "certification_date": "2021-11-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OH",
            "license": "30.026171",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Beryl Akinyi Nyambok Clark
• Brandi Clark
• Brandon Michael Clark
• Brigette Clark
• Caitlin Alysse Clark, PHARMD
• Carla Clark
• Carson Brandle Clark, MD
• Chad David Clark, MPAS, PA-C
• Charjan Clark
• Christopher Michael Clark, D.D.S.

• General Practice Dentistry in Columbus, OH
• Providers in Columbus, OH by specialty
• General Practice Dentistry in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 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.