NPIMap

Organization Active NPI

Clark a Dixon DMD PC

  • General Practice Dentistry
  • West Frankfort, IL
National Provider Identifier
1861512840
Registry record updated Jan 3, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
060.008005019.022512 Issued in IL
Legal business name
CLARK A DIXON DMD PC
Practice address
601 W Main St
West Frankfort, IL 62896-2232
Phone
(618) 937-1411
Fax
(618) 937-1911
NPI assigned
Mar 31, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 3, 2008

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

Authorized official

Name
Dr. Clark A Dixon, DMDNPI 1376693382
Title
President
Phone
(618) 937-1411

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 060.008005019.022512 IL Primary

Addresses

Primary practice location

601 W Main St
West Frankfort, IL 62896-2232

Mailing address

601 W Main St
West Frankfort, IL 62896-2232
Phone (618) 937-1411

National Provider Directory

National Provider Directory

Locations

601 W Main St
West Frankfort, IL 62896
Phone (618) 937-1411

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1175299200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1199318400000",
    "number": "1861512840",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 W MAIN ST",
            "city": "WEST FRANKFORT",
            "state": "IL",
            "postal_code": "628962232",
            "telephone_number": "618-937-1411",
            "fax_number": "618-937-1911"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 W MAIN ST",
            "city": "WEST FRANKFORT",
            "state": "IL",
            "postal_code": "628962232",
            "telephone_number": "618-937-1411",
            "fax_number": "618-937-1911"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLARK A DIXON DMD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-31",
        "last_updated": "2008-01-03",
        "status": "A",
        "authorized_official_last_name": "DIXON",
        "authorized_official_first_name": "CLARK",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "618-937-1411",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "060.008005019.022512",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Frankfort, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2008; 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.