Active NPI
Dominique Clark, DC
- Chiropractor
- Park Ridge, NJ
National Provider Identifier
1932071503
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 38MC00813900
- Practice address
- 17 Hawthorne Ave
Park Ridge, NJ 07656-1212 - Phone
- (201) 501-8984
- NPI assigned
- Sep 22, 2025
- Last updated
- Sep 22, 2025
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 38MC00813900 | NJ | Primary |
Addresses
Primary practice location
17 Hawthorne Ave
Park Ridge, NJ 07656-1212
Mailing address
17 Hawthorne Ave
Park Ridge, NJ 07656-1212
Phone (201) 501-8984
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 |
|---|---|---|---|
| 38MC00813900 | NJ | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1758499200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1758499200000",
"number": "1932071503",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "17 HAWTHORNE AVE",
"city": "PARK RIDGE",
"state": "NJ",
"postal_code": "076561212",
"telephone_number": "201-501-8984"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "17 HAWTHORNE AVE",
"city": "PARK RIDGE",
"state": "NJ",
"postal_code": "076561212",
"telephone_number": "201-501-8984"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CLARK",
"first_name": "DOMINIQUE",
"credential": "DC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2025-09-22",
"last_updated": "2025-09-22",
"certification_date": "2025-09-22",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "NJ",
"license": "38MC00813900",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Park Ridge, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.