Active NPI
Martin Thomas Clark, DDS
- Prosthodontics
- Oak Harbor, WA
National Provider Identifier
1861471153
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Prosthodontics
- License
- 0013317
- Practice address
- 3475 N Saratoga St
Oak Harbor, WA 98278-4927 - Phone
- (360) 257-4478
- NPI assigned
- Jan 13, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Prosthodontics | 1223P0700X | 0013317 | TX | Primary |
Addresses
Primary practice location
3475 N Saratoga St
Oak Harbor, WA 98278-4927
Mailing address
3475 N Saratoga St
Oak Harbor, WA 98278-4927
Phone (360) 257-4478
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 |
|---|---|---|---|
| 0013317 | TX | MD | Prosthodontist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1137110400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1192060800000",
"number": "1861471153",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3475 N SARATOGA ST",
"city": "OAK HARBOR",
"state": "WA",
"postal_code": "982784927",
"telephone_number": "360-257-4478"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3475 N SARATOGA ST",
"city": "OAK HARBOR",
"state": "WA",
"postal_code": "982784927",
"telephone_number": "360-257-4478"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CLARK",
"first_name": "MARTIN",
"middle_name": "THOMAS",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-01-13",
"last_updated": "2007-10-11",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0700X",
"taxonomy_group": "",
"desc": "Dentist, Prosthodontics",
"state": "TX",
"license": "0013317",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Oak Harbor, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.