DR. GUY CHARLES CLARK (NPI# 1215948286) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1215948286 |
| Entity Type | Individual |
| Full Name | DR. GUY CHARLES CLARK |
| Credential | D.D.S. PA |
| Practice Address |
3613 New Mexico Highway 528 Suite G Albuquerque NM 87114 |
| Practice Telephone | 5058988011 |
| Practice Fax Number | 5058907423 |
| Mailing Telephone | 5058988011 |
| Mailing Fax Number | 5058907423 |
| Enumeration Date | 2006-08-11 |
| 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 |
DD1139 | NM | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| UNITED CONCORDIA INSURANC | 141339 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235160789 | Guy Clark | Emergency Medicine | 601 S Concord St Ste 108, Knoxville, TN 37919-3339 | 2006-07-05 |
| 1356907083 | Guy Max Clark | Registered Nurse | 516 E Nizhoni Blvd, Gallup, NM 87301-5748 | 2019-05-17 |
| 1063574788 | Guy Clark | Internal Medicine | 2419 Castillo St, Santa Barbara, CA 93105-4301 | 2006-12-16 |
| Street Address |
3613 NEW MEXICO HIGHWAY 528 SUITE G |
| City | ALBUQUERQUE |
| State | NM |
| Zip Code | 87114 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891331773 | Head To Toe Wellness, LLC | Counselor | 4619 Greene Ave, Suite D, Albuquerque, NM 87114 | 2019-11-26 |
| 1255896353 | 32 Degrees Genuine, LLC | Counselor | 10143 4th St Nw, Albuquerque, NM 87114 | 2019-02-04 |
| 1548789365 | Maureen Chavez | Occupational Therapist | 10501 Golf Course, Albuquerque, NM 87114 | 2017-09-13 |
| 1982149043 | Professional Case Coordination Services LLC | Case Management | 4401 Aspen Glade Dr Nw, Albuquerque, NM 87114 | 2016-12-28 |
| 1124494323 | Geri Davis | Nurse Practitioner | 10511 Golf Course Rd Nw Ste 203, Albuquerque, NM 87114 | 2015-08-11 |
| 1427432111 | Marcia Nicole Cowen | Nurse Practitioner | 9210 Golfcourse Rd Nw, Albuquerque, NM 87114 | 2015-07-13 |
| 1013315399 | Amy Brown | Counselor | 707 Broadway Blvd. Ne, Suite 500, Albuquerque, NM 87114 | 2014-12-18 |
| 1851793392 | Elaine Barbara Beckett | Pharmacist | 10224 Coors-by-pass Nw, Albuquerque, NM 87114 | 2014-09-16 |
| 1174924344 | Sherrica Cressor | Counselor | 20 Pond Road, County Road 11, Cuba, NM 87114 | 2014-09-08 |
| 1427467513 | Colleen Temkin | Pharmacist | 10224 Coors By Pass Nw, Albuquerque, NM 87114 | 2014-08-04 |
| Find all providers in zip 87114 | ||||
| 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 |
|---|---|---|---|---|
| 1841803830 | Tri Dental, LLC | Dentist | 3715 Las Estancias Ct Sw Ste 101, Albuquerque, NM 87121-5506 | 2020-08-28 |
| 1609485077 | Joseph Potter | Dentist | 3510 Coors Blvd Sw, Albuquerque, NM 87121-5328 | 2020-07-30 |
| 1861024861 | Brian K Dennis Dds PC | Dentist | 8400 Osuna Rd Ne Ste 6a, Albuquerque, NM 87111-2073 | 2020-02-07 |
| 1134769235 | Abq Dentists PC | Dentist | 3900 Eubank Blvd Ne Ste 14, Albuquerque, NM 87111-3427 | 2020-01-07 |
| 1477197804 | Juan Tabo Dentistry LLC | Dentist | 1924 Juan Tabo Blvd Ne Ste C, Albuquerque, NM 87112-3358 | 2019-10-29 |
| 1013550094 | Bosque Smiles Dentistry, LLC | Dentist | 5600 Coors Blvd Nw Ste G4, Albuquerque, NM 87120-1877 | 2019-10-23 |
| 1134686298 | Brandon James Clayton | Dentist | 2003 Southern Blvd Se # 133-134, Albuquerque, NM 87124-3751 | 2019-02-25 |
| 1881158822 | Advantage Dental Care | Dentist | 9212 Montgomery Blvd Ne, Albuquerque, NM 87111-2408 | 2019-01-23 |
| 1124599253 | Kirtland Family Dentistry LLC | Dentist | 8521 Central Ave Ne Ste 101, Albuquerque, NM 87108-2501 | 2018-12-16 |
| 1962998443 | Salia Khayoumi | Dentist | 333 San Mateo Blvd Se, Albuquerque, NM 87108-2919 | 2018-07-08 |
| Find all providers in ALBUQUERQUE | ||||
| City | ALBUQUERQUE |
| Zip Code | 87114 |
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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.