DR. GRACE XINXING CLARK


Address: 4716 Illinois Rd Ste 101, Fort Wayne, IN 46804-5123
Phone: 2604327970

DR. GRACE XINXING CLARK (NPI# 1407360910) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1407360910
Entity Type Individual
Full Name DR. GRACE XINXING CLARK
Credential DDS
Practice Address 4716 Illinois Rd Ste 101
Fort Wayne
IN 46804-5123
Mailing Address 5120 Brookstone Way
Indianapolis
IN 46268-5417
Practice Telephone 2604327970
Mailing Telephone 8122516241
Enumeration Date 2017-11-20
Last Update Date 2018-01-12
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 1223G0001X Dentist
Specialization: General Practice
12012818A IN Dental Providers

Other Providers GRACE CLARK

NPI Name Taxonomy Address Enumeration
1750777009 Grace Clark Veterinarian 13160 Magisterial Dr, Louisville, KY 40223-4102 2015-04-14
1982027728 Grace D. Clark Counselor 11205 Lake Victoria Ln, Bowie, MD 20720-4262 2014-01-30
1932531274 Grace Teresa Clark Speech-Language Pathologist 3 Rambling Brook Rd, Upper Saddle River, NJ 07458-1110 2013-08-08
1972162840 Grace Margaret Clark Developmental Therapist 345a Greenwood St, Worcester, MA 01607-1753 2019-06-13
1780030734 Grace Clark Nurse Practitioner 3825 Medical Park Dr, Suite 100, Austell, GA 30106-6831 2016-05-09

Office Location

Street Address 4716 ILLINOIS RD STE 101
City FORT WAYNE
State IN
Zip Code 46804-5123

Providers in the same location

NPI Name Taxonomy Address Enumeration
1144846411 Thomas James Floyd Dentist 4716 Illinois Rd Ste 101, Fort Wayne, IN 46804-5123 2020-06-22

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1396350344 Derek Mumaw Physical Therapist 8420 Illinois Rd, Fort Wayne, IN 46804 2020-09-15
1942840228 Erin M Mason Behavior Technician 5601 Coventry Ln, Fort Wayne, IN 46804 2020-01-14
1346880879 Emily A Abdalla Behavior Technician 5601 Coventry Ln., Fort Wayne, IN 46804 2020-01-13
1083265433 Fort Wayne Endodontics Dentist 9407 Illinois Rd, Fort Wayne, IN 46804 2019-09-26
1689140949 Harrison Dental Group II, LLC Dentist 1333 Getz Rd, Fort Wayne, IN 46804 2018-10-15
1346731908 Erin Nicole Zimmerman Nurse Practitioner 10170 Illinois Rd # 14, Fort Wayne, IN 46804 2018-05-19
1417446022 Mary Harrington Physical Therapist 3320 Copper Hill Run, Fort Wayne, IN 46804 2018-05-09
1942701214 Joshawa Todd Torres Marriage & Family Therapist 5651 Coventry Ln # 116, Fort Wayne, IN 46804 2018-02-22
1194235408 Mitchell Kory Meyer Specialist/Technologist 9125 Yellow Tree Ct, Fort Wayne, IN 46804 2017-10-02
1902324916 Emily Rene Sagstetter Specialist/Technologist 6034 Liberty Glade Ct, Fort Wayne, IN 46804 2017-08-30
Find all providers in zip 46804

Taxonomy Information

Taxonomy Code 1223G0001X
Grouping Dental Providers
Classification Dentist
Specialization General Practice

Taxonomy Definition

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

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1679186258 James Patrick Thompson Dentist 5909 Wheelock Rd Ste 102, Fort Wayne, IN 46835-9258 2020-08-25
1295357481 Sycamore Hills Dentistry Dentist 10082 Illinois Rd, Fort Wayne, IN 46804-5772 2020-05-11
1699324103 Phillip M. Mckean Professional Corporation Dentist 6605 E State Blvd Ste 7, Fort Wayne, IN 46815-7036 2019-09-06
1598322083 Charles Chase Ellinwood Dentist 5725 Maplecrest Rd Ste 1, Fort Wayne, IN 46835-4937 2019-05-21
1689140949 Harrison Dental Group II, LLC Dentist 1333 Getz Rd, Fort Wayne, IN 46804 2018-10-15
1821582172 Jacob Yager Dentist 9830 Auburn Rd Ste 101, Fort Wayne, IN 46825-2464 2018-06-20
1740772656 Colleen Rose Allen Dentist 10213 Dupont Circle Dr W, Fort Wayne, IN 46825-1656 2018-06-06
1578959375 Ronald L Rumbaugh Dds PC Dentist 10506 Coldwater Rd, Fort Wayne, IN 46845-1235 2015-04-09
1619388063 Familia Dental Spfw Pllc Dentist 100 E Pettit Ave, 1a, Fort Wayne, IN 46806-3003 2014-05-19
1467792663 Familia Dental Fort Wayne Pllc Dentist 5328 Coldwater Rd, Fort Wayne, IN 46825-5445 2013-02-25
Find all providers in FORT WAYNE

Competitor

Search similar providers

City FORT WAYNE
Zip Code 46804

Improve Information

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Dataset Information

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.

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