Dakota B Clark DMD LLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

DAKOTA B CLARK DMD LLC

Doing business as

Jacksonville Comprehensive Dentistry

Practice address

1450 1St Ave SW
Jacksonville, AL 36265-3329

Phone

(256) 435-2007

NPI assigned

Oct 15, 2020

Last updated

Oct 15, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Dakota B Clark, DMDNPI 1417449349

Title

Owner

Phone

(256) 435-2007

Specialties & licenses 1

Addresses

Other names 1

• Jacksonville Comprehensive Dentistry Doing business as

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Dakota B Clark, DMD

  • General Practice Dentistry
  • Jacksonville, AL
  • NPI 1417449349
  NPD Authorized official
• Bruce Edward Cunningham, DMD

  • General Practice Dentistry
  • Jacksonville, AL
  • NPI 1215950753
  NPD (past)

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

{
    "created_epoch": "1602720000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1602720000000",
    "number": "1972101426",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1450 1ST AVE SW",
            "city": "JACKSONVILLE",
            "state": "AL",
            "postal_code": "362653329",
            "telephone_number": "256-435-2007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1450 1ST AVE SW",
            "city": "JACKSONVILLE",
            "state": "AL",
            "postal_code": "362653329",
            "telephone_number": "256-435-2007"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAKOTA B CLARK DMD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-10-15",
        "last_updated": "2020-10-15",
        "certification_date": "2020-10-15",
        "status": "A",
        "authorized_official_last_name": "CLARK",
        "authorized_official_first_name": "DAKOTA",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "256-435-2007",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Jacksonville Comprehensive Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Andra Cunningham
• Bruce Edward Cunningham, DMD
• T. David Cunningham Jr., LPC; NBCC
• Chandler Shannon Cupp
• Krystin Paige Cuthrell, LPC
• David G. Chandler, O.D.,P.C.
• Amanda Davis, D.M.D.
• Shawna Davis
• Bethany A Dean-Stoots
• Doctors Med Care of Jacksonville, P.C.

• General Practice Dentistry in Jacksonville, AL
• Providers in Jacksonville, AL by specialty
• General Practice Dentistry in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 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.