Devin Clark, DDS, PLLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

DEVIN CLARK, DDS, PLLC

Doing business as

Winlock Family Dentistry

Practice address

617 Cemetery Rd Ste a
Winlock, WA 98596-9303

Phone

(360) 785-4655

Fax

(360) 785-3336

NPI assigned

Jan 27, 2020

Last updated

Jan 27, 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. Devin Clark, DDSNPI 1952893026

Title

Owner/Member

Phone

(801) 808-3375

Specialties & licenses 1

Addresses

Other names 1

• Winlock Family Dentistry Doing business as

Locations

Practitioners 1

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.

• Devin Clark

  • Dentist
  • Winlock, WA
  • NPI 1952893026
  Authorized official Same address or phone

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

{
    "created_epoch": "1580083200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1580083200000",
    "number": "1992336127",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 399",
            "city": "WINLOCK",
            "state": "WA",
            "postal_code": "985960399",
            "telephone_number": "360-785-4755",
            "fax_number": "360-785-3336"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "617 CEMETERY RD STE A",
            "city": "WINLOCK",
            "state": "WA",
            "postal_code": "985969303",
            "telephone_number": "360-785-4655",
            "fax_number": "360-785-3336"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEVIN CLARK, DDS, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-01-27",
        "last_updated": "2020-01-27",
        "certification_date": "2020-01-27",
        "status": "A",
        "authorized_official_last_name": "CLARK",
        "authorized_official_first_name": "DEVIN",
        "authorized_official_title_or_position": "OWNER/MEMBER",
        "authorized_official_telephone_number": "801-808-3375",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Winlock Family Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Devin Clark
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• General Practice Dentistry in Winlock, WA
• Providers in Winlock, WA by specialty
• General Practice Dentistry in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 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.