H. Daniel Clark, DDS, MD

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

DS0000008111 Issued in TN

Practice address

3000 Stansberry LN
Suite 101
Franklin, TN 37069

Phone

(615) 591-0919

Fax

(615) 599-6762

NPI assigned

Oct 17, 2005

Last updated

Mar 22, 2013By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Jan 1, 2016 through Jan 1, 2028

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Southern Oral and Facial Surgery

  • Oral and Maxillofacial Surgery (Dentist)
  • Franklin, TN
  • NPI 1679671986
  NPD (past)

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

{
    "created_epoch": "1129507200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1363910400000",
    "number": "1932198694",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3000 STANSBERRY LN",
            "address_2": "SUITE 101",
            "city": "FRANKLIN",
            "state": "TN",
            "postal_code": "370695125",
            "telephone_number": "615-591-0919",
            "fax_number": "615-599-6762"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3000 STANSBERRY LN",
            "address_2": "SUITE 101",
            "city": "FRANKLIN",
            "state": "TN",
            "postal_code": "37069",
            "telephone_number": "615-591-0919",
            "fax_number": "615-599-6762"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "H.",
        "middle_name": "DANIEL",
        "name_prefix": "Dr.",
        "credential": "DDS, MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-17",
        "last_updated": "2013-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "TN",
            "license": "DS0000008111",
            "primary": true
        },
        {
            "code": "204E00000X",
            "taxonomy_group": "",
            "desc": "Oral & Maxillofacial Surgery",
            "state": "TN",
            "license": "MD0000037255",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kristin Elizabeth Ciorra, MS OTR/L
• Claiborne and Hughes Health Ctr
• Claiborne Management LLC
• Clarity Behavioral Health, PLLC
• Cortney Clark
• Karen N. Clark, RN
• Paige M Clark, PA
• Trisha Clark, OT
• Krystal Marie Clarke, NP
• Cara Leigh Clarkson Lau, MS, LPC-MHSP

• Oral and Maxillofacial Surgery (Dentist) in Franklin, TN
• Providers in Franklin, TN by specialty
• Oral and Maxillofacial Surgery (Dentist) in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.