Dennis Eugene Clark, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

36073 Issued in CA

Practice address

2121 Leeds Rd
Merced, CA 95340-9651

Phone

(209) 383-5561

Fax

(209) 383-5561

NPI assigned

Oct 3, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1444953600000",
    "number": "1780778050",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2121 LEEDS ROAD",
            "city": "MERCED",
            "state": "CA",
            "postal_code": "953409651"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2121 LEEDS RD",
            "city": "MERCED",
            "state": "CA",
            "postal_code": "953409651",
            "telephone_number": "209-383-5561",
            "fax_number": "209-383-5561"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "DENNIS",
        "middle_name": "EUGENE",
        "name_prefix": "Mr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-03",
        "last_updated": "2015-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "36073",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WA",
            "license": "DE00006780",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alondra Jacqueline Cisneros Barrera, ACSW
• Aaron Cisneros
• City of Merced
• Simren Claire, M.D.
• Christopher Clark, MD
• Michael R. Clark, OTR/L
• Halle Clementi, PT
• Andrew Cline
• Lisa Suzanne Clinton, M.S.P.T.
• Sara Clinton, RN 684418

• General Practice Dentistry in Merced, CA
• Providers in Merced, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2015; 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.