NPIMap

Organization Active NPI

Donald E. Clarke, D.D.S., Inc.

Doing business as Dental Source of California

  • Dental Clinic/Center
  • Sacramento, CA
National Provider Identifier
1992720627
Registry record updated Oct 14, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
License
33738 Issued in CA
Legal business name
DONALD E. CLARKE, D.D.S., INC.
Doing business as
Dental Source of California
Practice address
1930 9TH St Ste 105
Sacramento, CA 95811-7076
Phone
(916) 393-7336
NPI assigned
Jul 13, 2006
Last updated
Oct 14, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 14, 2020

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

Authorized official

Name
Dr. Donald Clarke, D.D.S.
Title
President of Corporation
Phone
(916) 486-0117

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X 33738 CA Primary

Addresses

Primary practice location

1930 9TH St Ste 105
Sacramento, CA 95811-7076

Mailing address

1930 9TH St Ste 105
Sacramento, CA 95811-7076
Phone (916) 393-7336

Other names 1

  • Dental Source of California Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Dental Source of California9 organizations share this tax ID, including this one

Other organizations with this tax ID 8

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1930 9th St
Ste 105
Sacramento, CA 95811
Phone (916) 393-7336

5914 Stockton Blvd
Sacramento, CA 95824
Phone (916) 393-7336

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1152748800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1602633600000",
    "number": "1992720627",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1930 9TH ST STE 105",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958117076",
            "telephone_number": "916-393-7336",
            "fax_number": "916-393-6493"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1930 9TH ST STE 105",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958117076",
            "telephone_number": "916-393-7336"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DONALD E. CLARKE, D.D.S., INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-13",
        "last_updated": "2020-10-14",
        "certification_date": "2020-10-14",
        "status": "A",
        "authorized_official_last_name": "CLARKE",
        "authorized_official_first_name": "DONALD",
        "authorized_official_title_or_position": "PRESIDENT OF CORPORATION",
        "authorized_official_telephone_number": "916-486-0117",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "CA",
            "license": "33738",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dental Source of California",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Dental Source of California",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Sacramento, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 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.