DR. MICHAEL V. CLARK (NPI# 1386778520) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1386778520 |
| Entity Type | Individual |
| Full Name | DR. MICHAEL V. CLARK |
| Credential | DDS |
| Practice Address |
6900 Yellowtail Rd Suite 100 Cheyenne WY 82009-6102 |
| Practice Telephone | 3076359251 |
| Practice Fax Number | 3076359218 |
| Mailing Telephone | 3076359251 |
| Mailing Fax Number | 3076359218 |
| Enumeration Date | 2007-03-16 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223P0221X |
Dentist Specialization: Pediatric Dentistry |
1108 | WY | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WY | 119846700 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215534227 | Michael Clark | Contractor | 1107 Lavender Shade Court, Houston, TX 77073 | 2020-10-02 |
| 1558858464 | Michael Clark | Optometrist | 990 Medical Dr Ste G3, Brigham City, UT 84302 | 2018-04-16 |
| 1740780006 | Michael Ryan Clark | Pharmacist | 556 Northside Drive, Statesboro, GA 30458 | 2018-02-13 |
| 1942715255 | Michael Clark | Physical Medicine & Rehabilitation | 10600 Riverside Drive, Coral Springs, FL 33071-3307 | 2017-12-08 |
| 1386170348 | Michael Clark | Registered Nurse | 317 E 100 N, Price, UT 84501-2504 | 2017-05-11 |
| 1184163982 | Michael Clark | Specialist/Technologist | 19 Second Ave, Auburn, NY 13021-5113 | 2017-02-14 |
| 1356780837 | Michael Clark | Adult Companion | 8305 Concord Dr, Rowlett, TX 75089-2001 | 2013-06-18 |
| 1417394503 | Michael Ray Clark | Pharmacist | 2661 Valleydale Rd, Hoover, AL 35244-2026 | 2013-05-29 |
| 1407143381 | Michael Jeffery Clark | Orthopaedic Surgery | 5671 Peachtree Dunwoody Ste 700, Atlanta, GA 30342-5047 | 2011-06-29 |
| 1700183993 | Michael Brady Clark | Preventive Medicine | 1400 Mckean Rd, Spring House, PA 19477 | 2011-02-24 |
| Street Address |
6900 YELLOWTAIL RD SUITE 100 |
| City | CHEYENNE |
| State | WY |
| Zip Code | 82009-6102 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518091859 | Jay Q. Cole | Dentist | 6900 Yellowtail Rd, Suite 100, Cheyenne, WY 82009-6102 | 2007-03-16 |
| 1851723860 | Erin Asay | Dentist | 6900 Yellowtail Rd, Suite 100, Cheyenne, WY 82009-6102 | 2013-07-31 |
| 1932448602 | Cole A. Weaver | Dentist | 6900 Yellowtail Rd, Cheyenne, WY 82009-6102 | 2013-01-31 |
| 1154550028 | Patricia Genho | Dentist | 6900 Yellowtail Rd, Cheyenne, WY 82009-6102 | 2009-07-13 |
| 1649488743 | Children's Dentistry LLC | Dentist | 6900 Yellowtail Rd, Cheyenne, WY 82009-6102 | 2007-05-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659840841 | King & Associates LLC | Private Vehicle | 2232 Dell Range Blvd 245 #3083 Cheyenne, Cheyenne, WY 82009 | 2018-11-16 |
| 1710495700 | Wyoming Endoscopy Center LLC | Clinic/Center | 7220 Comons Circle, Cheyenne, WY 82009 | 2018-01-12 |
| 1912442682 | Lindsey Thurmes Mccoy | Dietitian, Registered | 2232 Dell Range Blvd Ste 282, Cheyenne, WY 82009 | 2017-01-04 |
| 1306380696 | Alexandra Gill | Social Worker | 3304 East 1-80 Service Rd., Cheyenne, WY 82009 | 2016-12-06 |
| 1104213859 | Jennifer Schwartz | Specialist | 2601 Plain View Rd, Cheyenne, WY 82009 | 2015-04-21 |
| 1861830465 | Tyler Boyd | Dentist | 7209 Commons Cir Unit A, Cheyenne, WY 82009 | 2013-06-05 |
| 1639513351 | Gene E Darnell | Pharmacist | 3702 Del Range Blvd, Cheyenne, WY 82009 | 2013-04-24 |
| 1376891952 | Robert R Kanard | Internal Medicine | 714 Edward Dr, Cheyenne, WY 82009 | 2012-08-29 |
| 1639443336 | Jennifer Alam | Case Manager/Care Coordinator | 3304 E. I80 Service Rd, Cheyenne, WY 82009 | 2012-02-28 |
| 1376815357 | Christina Kay Brown | Licensed Practical Nurse | 3304 E I80 Service Rd, Cheyenne, WY 82009 | 2012-02-06 |
| Find all providers in zip 82009 | ||||
| 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 |
|---|---|---|---|---|
| 1518091859 | Jay Q. Cole | Dentist | 6900 Yellowtail Rd, Suite 100, Cheyenne, WY 82009-6102 | 2007-03-16 |
| 1477571610 | John Reichmann Leonard | Dentist | 1439 Stillwater Ave Ste 7, Cheyenne, WY 82009-7367 | 2006-07-17 |
| 1265848774 | Pediatric Dentistry LLC | Dentist | 1439 Stillwater Ave Ste 7, Cheyenne, WY 82009-7367 | 2014-07-03 |
| 1447562012 | Vision Ayuda, Inc. | Dentist | 1439 Stillwater Ave, Suite 7, Cheyenne, WY 82009-7367 | 2010-07-12 |
| 1649488743 | Children's Dentistry LLC | Dentist | 6900 Yellowtail Rd, Cheyenne, WY 82009-6102 | 2007-05-21 |
| 1326118993 | Pediatric Dentistry, P.C. | Dentist | 1439 Stillwater Ave Ste 7, Cheyenne, WY 82009-7367 | 2006-11-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942775960 | Clubhouse Pediatric Dentistry of Jackson | Dentist | 1130 Us-89, Jackson Hole, WY 83001-8701 | 2018-10-05 |
| 1891218392 | Matthew Gary Wold | Dentist | 5040 E 2nd St Ste 2, Casper, WY 82609-4468 | 2017-07-18 |
| 1013289966 | Gillette Pediatric Dentistry LLC | Dentist | 433 Shadow Ridge Blvd, Sheridan, WY 82801-9350 | 2012-02-07 |
| 1477862076 | David G Bailey | Dentist | 531 Coffeen Ave, Sheridan, WY 82801-5311 | 2010-09-29 |
| 1972822930 | Abc Pediatric Dentistry, LLC | Dentist | 610 S 4j Ct # B, Gillette, WY 82716-4127 | 2010-05-28 |
| 1750584173 | Roy E. Paulson Jr PC | Dentist | 102 N. Kenwood St., Casper, WY 82601-2724 | 2007-06-06 |
| 1821207036 | Roy E. Paulson Jr PC | Dentist | 2805 Cedar Ave Ste A, Gillette, WY 82718-2000 | 2007-05-22 |
| 1760520514 | L Grant Christensen | Dentist | 657 Pilot Butte Ave, Rock Springs, WY 82901-5343 | 2007-02-02 |
| 1750459319 | David A Krise | Dentist | 25 Pebbles Lane, Lander, WY 82520 | 2006-12-01 |
| 1104921907 | Roy E Paulson | Dentist | 102 N Kenwood, Casper, WY 82601 | 2006-09-14 |
| Find all providers with the same taxonomy | ||||
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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.