Active NPI
Kyle Warner Clark, D.M.D.
- Dentist
- Cleveland Heights, OH
National Provider Identifier
1891955662
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 7023394-8903
- Practice address
- 1008 Rushleigh Rd
Cleveland Heights, OH 44121-1415 - Phone
- (801) 722-4847
- NPI assigned
- Jun 14, 2008
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Dentist | 122300000X | 7023394-8903 | UT | Primary |
Addresses
Primary practice location
1008 Rushleigh Rd
Cleveland Heights, OH 44121-1415
Mailing address
1008 Rushleigh Rd
Cleveland Heights, OH 44121-1415
Phone (801) 722-4847
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 |
|---|---|---|---|
| 7023394-8903 | UT | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1213401600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1213401600000",
"number": "1891955662",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1008 RUSHLEIGH RD",
"city": "CLEVELAND HEIGHTS",
"state": "OH",
"postal_code": "441211415",
"telephone_number": "801-722-4847"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1008 RUSHLEIGH RD",
"city": "CLEVELAND HEIGHTS",
"state": "OH",
"postal_code": "441211415",
"telephone_number": "801-722-4847"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CLARK",
"first_name": "KYLE",
"middle_name": "WARNER",
"name_prefix": "Dr.",
"credential": "D.M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-06-14",
"last_updated": "2008-06-14",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "UT",
"license": "7023394-8903",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Cleveland Heights, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 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.