DR. JASON DREW CLARK (NPI# 1346201431) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1346201431 |
| Entity Type | Individual |
| Full Name | DR. JASON DREW CLARK |
| Credential | D.D.S. |
| Practice Address |
7810 Providence Rd Suite 100 Charlotte NC 28226-2987 |
| Practice Telephone | 7045433766 |
| Practice Fax Number | 7045433768 |
| Mailing Telephone | 7045433766 |
| Mailing Fax Number | 7045433768 |
| Enumeration Date | 2006-03-29 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | X |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223P0221X |
Dentist Specialization: Pediatric Dentistry |
6966 | NC | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | 8990141 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033727425 | Jason Clark | Counselor | 2451 N Lincoln Ave Side 2, Chicago, IL 60614-4170 | 2020-07-21 |
| 1548695489 | Jason S. Clark | Veterinarian | 11800 Capital Way, Louisville, KY 40299-6332 | 2013-09-11 |
| 1306197348 | Jason Clark | Nurse Anesthetist, Certified Registered | 620 Skyline Drive, Jackson, TN 38301 | 2012-10-01 |
| 1568711513 | Jason E Clark | Case Management | 4615 Philips Highway, Jacksonville, FL 32207-7265 | 2012-09-06 |
| 1699024695 | Jason M Clark | Optometrist | 101 Conley Rd, Columbia, MO 65201-6465 | 2012-09-05 |
| 1457632705 | Jason Clark | Physical Therapy Assistant | 1001 Giesau Dr, Ontonagon, MI 49953-1454 | 2011-08-31 |
| 1184912883 | Jason Clark | Pharmacist | 3021 Reidville Rd, Spartanburg, SC 29301-5643 | 2011-07-14 |
| 1508150301 | Jason Clark | Occupational Therapist | 140 Technology Ln, Johnson City, TN 37604-2004 | 2011-06-09 |
| 1902101959 | Jason Andrew Clark | Nurse Anesthetist, Certified Registered | 1970 Roanoke Blvd, Salem, VA 24153-6404 | 2011-01-24 |
| 1134448525 | Jason D Clark | Orthopaedic Surgery | 480 E Jefferson St, Suite B, Butler, PA 16001-4780 | 2010-05-25 |
| Street Address |
7810 PROVIDENCE RD SUITE 100 |
| City | CHARLOTTE |
| State | NC |
| Zip Code | 28226-2987 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891311312 | Taylor Niara Ross | Physician Assistant | 7810 Providence Rd, Charlotte, NC 28226-2954 | 2020-06-20 |
| 1063044063 | Susannah Short | Nurse Practitioner | 7810 Providence Rd, Ste 102, Charlotte, NC 28226-2954 | 2020-02-07 |
| 1588220586 | Fikile Mpofu | Nurse Practitioner | 7810 Providence Rd, Ste 102, Charlotte, NC 28226-2954 | 2019-05-15 |
| 1417455809 | Andrea Wallace | Nurse Practitioner | 7810 Providence Rd, Ste 102, Charlotte, NC 28226-2954 | 2018-01-31 |
| 1588188155 | Margaret Richards | Nurse Practitioner | 7810 Providence Rd, Ste 102, Charlotte, NC 28226-2954 | 2017-07-26 |
| 1083033161 | Laura Pekman | Obstetrics & Gynecology | 7810 Providence Rd, Ste 101, Charlotte, NC 28226-2954 | 2014-04-16 |
| 1295150449 | Thomas Tate | Physician Assistant | 7810 Providence Rd, Ste 102, Charlotte, NC 28226-2954 | 2014-02-25 |
| 1154666402 | Kay A Love | Nurse Practitioner | 7810 Providence Rd, Suite 102, Charlotte, NC 28226-2954 | 2012-11-27 |
| 1205182359 | Shonda Bowers | Nurse Practitioner | 7810 Providence Rd, Ste 102, Charlotte, NC 28226-2954 | 2012-07-26 |
| 1639461296 | Joshua Counihan | Obstetrics & Gynecology | 7810 Providence Rd, Ste 105, Charlotte, NC 28226-2954 | 2011-05-13 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841837507 | Southeast Vulvar Clinic, Pllc | Dermatology | 6406 Carmel Road, Suite 309, Charlotte, NC 28226 | 2019-12-02 |
| 1427540012 | Kenneth William Riley Jr. | Behavioral Analyst | 10953 Park Rd., Charlotte, NC 28226 | 2018-05-31 |
| 1780103838 | Tamara Andres | Specialist/Technologist | 2518 Lawton Bluff Rd., Charlotte, NC 28226 | 2017-09-10 |
| 1083132609 | Xenon Anesthesia of North Carolina Pllc | Anesthesiology | 7006 Shannon Willow Road, Charlotte, NC 28226 | 2017-09-04 |
| 1104354117 | Lauren Nicole Brindisi | Chiropractor | 11230 Carmel Commons Blvd., Charlotte, NC 28226 | 2017-06-03 |
| 1346790821 | Carolinas Skin Center Pa | Plastic Surgery | 3315 Springbank Lane, Suite 202, Charlotte, NC 28226 | 2016-10-10 |
| 1871040469 | Julie R Jackson | Counselor | 7810 Prineville-mathews Road, Charlotte, NC 28226 | 2016-09-01 |
| 1518346105 | Christopher Abernathy | Dentist | 3111 Springbank Ln Ste A, Charlotte, NC 28226 | 2015-05-28 |
| 1285067504 | Amy N Bullock | Physical Therapist | 7207 Marcel Ln Apt 1138, Charlotte, NC 28226 | 2013-08-11 |
| 1528405297 | Elevate Counseling and Clinical Services, Pllc | Community/Behavioral Health | 107220 Carmel Commons Blvd., Ste. 320, Charlotte, NC 28226 | 2013-06-04 |
| Find all providers in zip 28226 | ||||
| Taxonomy Code | 1223P0221X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Pediatric Dentistry |
| An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336607340 | Arpita Patel, Dmd, Pa | Dentist | 2400 South Blvd Ste 100, Charlotte, NC 28203-5773 | 2019-03-08 |
| 1598247579 | S. Vakil Dds Ms I, Pa | Dentist | 6331 Carmel Rd Ste 101, Charlotte, NC 28226-8246 | 2018-09-05 |
| 1366971384 | Young and Polite Young Dds Pa | Dentist | 3010 Baucom Rd Ste 100, Charlotte, NC 28269-6767 | 2017-06-05 |
| 1174972756 | Brandy Edmonds | Dentist | 2630 W Arrowood Rd Ste C, Charlotte, NC 28273-6263 | 2016-06-06 |
| 1487032850 | John Michael Bakarich | Dentist | 7741 Ballantyne Commons Pkwy Ste 101, Charlotte, NC 28277-4140 | 2015-05-18 |
| 1568840403 | Carson Rutledge | Dentist | 2700 Coltsgate Rd Ste 204, Charlotte, NC 28211-3573 | 2015-05-12 |
| 1578962254 | Sonam Shah Patel | Dentist | 17214 Lancaster Hwy Ste 301, Charlotte, NC 28277-2093 | 2014-08-18 |
| 1215343421 | Marcela Mujica Dmd | Dentist | 2630 W Arrowood Rd, Suite C, Charlotte, NC 28273-6134 | 2014-07-08 |
| 1841626835 | R. Corey Snow, Dmd and Jason K. Snow, Dds, Pllc | Dentist | 2620 Central Ave, Charlotte, NC 28205-5335 | 2013-09-23 |
| 1427344357 | Oscar Nzita Mvula | Dentist | 1515 Mainline Blvd, Apt 7202, Charlotte, NC 28203-0521 | 2011-06-20 |
| Find all providers in CHARLOTTE | ||||
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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.