Brian Clarke, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

9192 Issued in NC

Practice address

2435 Plantation Center Dr
Suite 100
Matthews, NC 28105-5147

Phone

(773) 934-9368

NPI assigned

Jul 19, 2011

Sex

Male

Sole proprietor

No

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

Enrolled in NC

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1311033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1311033600000",
    "number": "1811285349",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2435 PLANTATION CENTER DR",
            "address_2": "SUITE 100",
            "city": "MATTHEWS",
            "state": "NC",
            "postal_code": "281055147",
            "telephone_number": "773-934-9368"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2435 PLANTATION CENTER DR",
            "address_2": "SUITE 100",
            "city": "MATTHEWS",
            "state": "NC",
            "postal_code": "281055147",
            "telephone_number": "773-934-9368"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARKE",
        "first_name": "BRIAN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-07-19",
        "last_updated": "2011-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NC",
            "license": "9192",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jamie Chuu, PHARMD
• Allison M. Clark, MSPT
• Brenda Lou Clark, FNP
• Riana Clark
• Stacy Marie Clark, PT
• Leigh Sullivan Clavin, RPH
• Clear View Eye Care, OD, PA
• Holly Kristine Clemens, D.C.
• Thomas Robert Clinton, PT
• Steven Patrick Clune, PT

• General Practice Dentistry in Matthews, NC
• Providers in Matthews, NC by specialty
• General Practice Dentistry in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.