Dow Clark Dental Associates

Primary specialty

DentistTaxonomy code 122300000X

Legal business name

DOW CLARK DENTAL ASSOCIATES

Practice address

6188 Oxon Hill Rd
Suite 604
Oxon Hill, MD 20745-3113

Phone

(301) 686-1070

Fax

(301) 686-1072

NPI assigned

Aug 18, 2009

Last updated

Aug 18, 2009By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Fredrick Douglass Clark, DDSNPI 1417067281

Title

Lead Doctor

Phone

(301) 686-1070

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Fredrick Douglass Clark, DDS

  • Dentist
  • Oxon Hill, MD
  • NPI 1417067281
  Authorized official Same address or phone

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

{
    "created_epoch": "1250553600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1250553600000",
    "number": "1821220294",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6188 OXON HILL RD",
            "address_2": "SUITE 604",
            "city": "OXON HILL",
            "state": "MD",
            "postal_code": "207453113",
            "telephone_number": "301-686-1070",
            "fax_number": "301-686-1072"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6188 OXON HILL RD",
            "address_2": "SUITE 604",
            "city": "OXON HILL",
            "state": "MD",
            "postal_code": "207453113",
            "telephone_number": "301-686-1070",
            "fax_number": "301-686-1072"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DOW CLARK DENTAL ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-08-18",
        "last_updated": "2009-08-18",
        "status": "A",
        "authorized_official_last_name": "CLARK",
        "authorized_official_first_name": "FREDRICK",
        "authorized_official_middle_name": "DOUGLASS",
        "authorized_official_title_or_position": "LEAD DOCTOR",
        "authorized_official_telephone_number": "301-686-1070",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "05724244",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Dentist in Oxon Hill, MD
• Providers in Oxon Hill, MD by specialty
• Dentist in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2009; 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.