Active NPI
Calli Layne Clark, DMD
- Pediatric Dentistry
- North Charleston, SC
National Provider Identifier
1811642895
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Dentistry
- License
- 10937
- Practice address
- 8600 Dorchester Rd Ste 104
North Charleston, SC 29420-7382 - Phone
- (843) 473-6636
- NPI assigned
- Feb 17, 2022
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Dentistry | 1223P0221X | 10937 | SC | Primary |
| Dentist | 122300000X | 10733 | SC |
Addresses
Primary practice location
8600 Dorchester Rd Ste 104
North Charleston, SC 29420-7382
Mailing address
180 Patriots Point Rd Apt 503
Mount Pleasant, SC 29464-5437
Phone (570) 394-8245
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 10733 | SC | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1645056000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1786147200000",
"number": "1811642895",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "180 PATRIOTS POINT RD APT 503",
"city": "MOUNT PLEASANT",
"state": "SC",
"postal_code": "294645437",
"telephone_number": "570-394-8245"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8600 DORCHESTER RD STE 104",
"city": "NORTH CHARLESTON",
"state": "SC",
"postal_code": "294207382",
"telephone_number": "843-473-6636"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CLARK",
"first_name": "CALLI",
"middle_name": "LAYNE",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-02-17",
"last_updated": "2026-08-08",
"certification_date": "2026-08-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0221X",
"taxonomy_group": "",
"desc": "Dentist, Pediatric Dentistry",
"state": "SC",
"license": "10937",
"primary": true
},
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "SC",
"license": "10733",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in North Charleston, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.