Waleed Ajamu Clark, DDS

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

8057 Issued in NC

Practice address

1813 Eastchester Dr
Suite 100
High Point, NC 27265-1573

Phone

(336) 882-0345

NPI assigned

Oct 10, 2006

Sex

Male

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• W.a. Clark, D.D.S., P.L.L.C.

  • Dentist
  • Oklahoma City, OK
  • NPI 1740521509
  NPD (past) Authorized official
• W.a. Clark D.D.S., P.L.L.C.

  • Pediatric Dentistry
  • High Point, NC
  • NPI 1497116313
  NPD (past)

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

{
    "created_epoch": "1160438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1483574400000",
    "number": "1851489447",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "612 BELLEMEADE ST",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274011903",
            "telephone_number": "202-271-3096"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1813 EASTCHESTER DR",
            "address_2": "SUITE 100",
            "city": "HIGH POINT",
            "state": "NC",
            "postal_code": "272651573",
            "telephone_number": "336-882-0345"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "WALEED",
        "middle_name": "AJAMU",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-10",
        "last_updated": "2017-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "NC",
            "license": "8057",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christyhealth Care Services
• Chrysalis
• Ugonma Igwe Chukwuma, FNP
• Cecilia Elle Cioffi
• Cameron Taylor Clark, PA-C
• Greg Lawson Clary, MD
• Classy Home Care Transportation Service
• Classy Senior Home Care, LLC
• Jennifer D. Clayton, PH.D.
• Joshua Vincent Clemente

• Pediatric Dentistry in High Point, NC
• Providers in High Point, NC by specialty
• Pediatric Dentistry in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2017; 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.