Adriana Del Pilar Clark, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

55988 Issued in CA

Practice address

1830 Commercial Way
Santa Cruz, CA 95065-1819

Phone

(831) 464-5409

NPI assigned

Dec 15, 2009

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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.

• Dientes Community Dental Care.

  • Dentist
  • Santa Cruz, CA
  • NPI 1437213279
  NPD (past)

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

{
    "created_epoch": "1260835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687392000000",
    "number": "1922337245",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1830 COMMERCIAL WAY",
            "city": "SANTA CRUZ",
            "state": "CA",
            "postal_code": "950651819",
            "telephone_number": "831-464-5409"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1830 COMMERCIAL WAY",
            "city": "SANTA CRUZ",
            "state": "CA",
            "postal_code": "950651819",
            "telephone_number": "831-464-5409"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "ADRIANA",
        "middle_name": "DEL PILAR",
        "name_prefix": "Mrs.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-12-15",
        "last_updated": "2023-06-22",
        "certification_date": "2023-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "55988",
            "primary": true
        },
        {
            "code": "1223D0001X",
            "taxonomy_group": "",
            "desc": "Dentist, Dental Public Health",
            "state": "CA",
            "license": "55988",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Guadalupe Cisneros
• Kevin Osugi Cisneros
• Stephanie None Cisneros
• Gianluca Ciulla, CMT
• Ellen Clack
• Derrick J Clark, PHD
• Jennifer Clark, LMFT
• Kacy Clark
• Meg Kristine Clark
• Ron Wayne Clark

• General Practice Dentistry in Santa Cruz, CA
• Providers in Santa Cruz, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2023; 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.