Clark Dental Care Inc

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

CLARK DENTAL CARE INC

Practice address

1980 A Kings Gate Rd
Suite a
Springfield, OH 45502

Phone

(937) 342-5370

NPI assigned

Jan 11, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Kamal Abdel Basir Abdel Wahab, DDSNPI 1568608610

Title

President

Phone

(937) 342-5370

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 1

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

• Kamal A Abdel-Wahab, D.D.S.

  • General Practice Dentistry
  • Springfield, OH
  • NPI 1568608610
  NPD (past) Authorized official

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

{
    "created_epoch": "1168473600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1891845160",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 655",
            "city": "URBANA",
            "state": "OH",
            "postal_code": "43078",
            "telephone_number": "937-342-5370"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1980 A KINGS GATE RD",
            "address_2": "SUITE A",
            "city": "SPRINGFIELD",
            "state": "OH",
            "postal_code": "45502",
            "telephone_number": "937-342-5370"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLARK DENTAL CARE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-11",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ABDEL WAHAB",
        "authorized_official_first_name": "KAMAL",
        "authorized_official_middle_name": "ABDEL BASIR",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "937-342-5370",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0679565",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Clark County
• Clark County Dialysis Facility, Inc.
• Clark County Educational Service Center
• Clark County Educational Service Center
• Clark County Sheriff'S Office
• Clark Radiation Oncology
• Clark-Shawnee Local Schools
• Amanda Lynn Clark, RN
• Eric Clark
• Jennifer Clark

• General Practice Dentistry in Springfield, OH
• Providers in Springfield, OH by specialty
• General Practice Dentistry in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.