DR. CLEOPHUS BENSON CLARK (NPI# 1114022720) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114022720 |
| Entity Type | Individual |
| Full Name | DR. CLEOPHUS BENSON CLARK |
| Credential | DDS |
| Practice Address |
5695 King Centre Dr Suite B100 Alexandria VA 22315-5744 |
| Practice Telephone | 7037199824 |
| Practice Fax Number | 7037196206 |
| Mailing Telephone | 7037199824 |
| Mailing Fax Number | 7037196206 |
| Enumeration Date | 2006-09-14 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
3822 | VA | Dental Providers |
| Street Address |
5695 KING CENTRE DR SUITE B100 |
| City | ALEXANDRIA |
| State | VA |
| Zip Code | 22315-5744 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962920108 | Alexandra Shields | Physical Therapist | 5695 King Centre Dr, Alexandria, VA 22315-5744 | 2017-09-08 |
| 1245763598 | Susanne Petra Cook | Speech-Language Pathologist | 5695 King Centre Dr, Ste. 100, Alexandria, VA 22315-5744 | 2017-04-04 |
| 1720438880 | Cara Lynn Koshut | Speech-Language Pathologist | 5695 King Centre Dr, Ste. 100, Alexandria, VA 22315-5744 | 2016-06-20 |
| 1801244934 | Rachel Bauer | Speech-Language Pathologist | 5695 King Centre Dr, Ste 100, Alexandria, VA 22315-5744 | 2016-05-31 |
| 1891157541 | Ashley Brown | Occupational Therapist | 5695 King Centre Dr, Suite 100, Alexandria, VA 22315-5744 | 2016-03-22 |
| 1588021588 | Lindsay Lustig | Physical Therapist | 5695 King Centre Dr, Ste. 100, Alexandria, VA 22315-5744 | 2016-01-21 |
| 1134503444 | C Benson Clark, Dds, PC | Dentist | 5695 King Centre Dr, Ste. B-100, Alexandria, VA 22315-5744 | 2015-07-16 |
| 1487042594 | Nicole R Crozier | Occupational Therapist | 5695 King Centre Dr, Suite 100, Alexandria, VA 22315-5744 | 2014-12-26 |
| 1033430467 | Celeste Sigua Balino | Dentist | 5695 King Centre Dr, Suite B100, Alexandria, VA 22315-5744 | 2010-06-21 |
| 1902904741 | Raymond F Young | Dentist | 5695 King Centre Dr, Suite B100, Alexandria, VA 22315-5744 | 2006-09-20 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861871865 | Wegmans Food Markets, Inc. | Pharmacy | 7905 Hilltop Village Center Drive, Alexandria, VA 22315 | 2015-05-22 |
| 1255731071 | Jennifer Becker | Registered Nurse | 6061 Joust Ln, Alexandria, VA 22315 | 2014-08-28 |
| 1386908564 | Gregory James Davis | Pharmacist | 7100 Silver Lake Rd, Alexandria, VA 22315 | 2012-07-02 |
| 1447525910 | Tersit Menberu Gulelat | Pharmacist | 7216 Lake Cove Dr, Alexandria, VA 22315 | 2012-03-17 |
| 1720392871 | Hung Quoc Chau Lu | Dentist | 6479 Old Beulah St, Alexandria, VA 22315 | 2010-07-31 |
| 1962727958 | Armin Susan Razavi | Obstetrics & Gynecology | 5420 Castle Bar Ln, Alexandria, VA 22315 | 2010-04-01 |
| 1205027463 | Roberts Home Medical LLC | Durable Medical Equipment & Medical Supplies | 5680 King Centre Dr Ste 673, Alexandria, VA 22315 | 2007-08-05 |
| 1114045606 | Amanuel Haileab | Pharmacist | 6400 Lansdown Center, Cvs Pharmacy, Alexandria, VA 22315 | 2007-03-26 |
| 1336265859 | Arnold B Braff | Optometrist | 5800 Kingstowne Blvd, Alexandria, VA 22315 | 2007-03-22 |
| 1154404622 | Don J Pisciotta | Dentist | 6408 Grovedale Drive, Suite 100, Franconia, VA 22315 | 2006-10-20 |
| Find all providers in zip 22315 | ||||
| Taxonomy Code | 1223G0001X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | General Practice |
| A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. |
| Notes: Source: Academy of General Dentistry |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477154516 | Kim Ierna Kitchen Dds, PC | Dentist | 500 Montgomery St Ste 250, Alexandria, VA 22314-1558 | 2020-11-05 |
| 1477117778 | Galleria Dental of Alexandria Pllc | Dentist | 3223 Duke St Ste G, Alexandria, VA 22314-4555 | 2019-04-23 |
| 1609333178 | Sebastian Gonzalez-diaz | Dentist | 3709 Masonic Dr, Alexandria, LA 71301-3632 | 2019-02-20 |
| 1952896383 | Christy Park Hark | Dentist | 901 N Washington St Ste 202, Alexandria, VA 22314-1535 | 2018-06-27 |
| 1144714718 | Taylor Eve Sylvester | Dentist | 2014 Gus Kaplan Dr, Alexandria, LA 71301-3358 | 2018-06-18 |
| 1396259586 | Sasan Ahmadiyar, Dds,pllc | Dentist | 1911 Ballenger Ave, Alexandria, VA 22314-6819 | 2017-11-27 |
| 1891205993 | Caroline Young Lee | Dentist | 4452 Raleigh Ave Apt 201, Alexandria, VA 22304-6744 | 2017-10-03 |
| 1578091591 | Timothy Yang | Dentist | 5249 Duke St # L-10, Alexandria, VA 22304-2926 | 2017-06-03 |
| 1659827871 | Tesfaye A Hailemariam Dds PC | Dentist | 5764 Dow Ave, Alexandria, VA 22304 | 2016-08-28 |
| 1902359409 | Emily Chow | Dentist | 1725 Duke St, Suite Gr03, Alexandria, VA 22314 | 2016-08-01 |
| Find all providers in ALEXANDRIA | ||||
| City | ALEXANDRIA |
| Zip Code | 22315 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.