David John Clark, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

06823 Issued in IA

Practice address

211 West Main Street
Marshalltown, IA 50158

Phone

(641) 752-3651

Fax

(641) 752-3653

NPI assigned

Jul 28, 2006

Last updated

Jul 8, 2007By the provider in NPPES

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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in IA

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

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

{
    "created_epoch": "1154044800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1831103308",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "211 WEST MAIN STREET",
            "city": "MARSHALLTOWN",
            "state": "IA",
            "postal_code": "50158",
            "telephone_number": "641-752-3651",
            "fax_number": "641-752-3653"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "211 WEST MAIN STREET",
            "city": "MARSHALLTOWN",
            "state": "IA",
            "postal_code": "50158",
            "telephone_number": "641-752-3651",
            "fax_number": "641-752-3653"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "DAVID",
        "middle_name": "JOHN",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-28",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IA",
            "license": "06823",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0207472",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kin-Kwan Tony Cheuk, M.D.
• China Connection Global Healthcare
• Erik Svend Christensen, D.D.S.
• City of Marshalltown
• Clark and Associates, Inc
• Emily Renee Clawson, ARNP
• Clinic Investments, Inc.
• John G Collison, D.D.S.
• McKenzie Mae Cooper
• Kellen Cormier, MA

• General Practice Dentistry in Marshalltown, IA
• Providers in Marshalltown, IA by specialty
• General Practice Dentistry in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.