DR. JERRY R CLARK (NPI# 1619203551) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1619203551 |
| Entity Type | Individual |
| Full Name | DR. JERRY R CLARK |
| Credential | DDS, MS |
| Practice Address |
1115 W Friendly Ave Greensboro NC 27401-1844 |
| Practice Telephone | 3362732528 |
| Practice Fax Number | 3362738038 |
| Mailing Telephone | 3362732528 |
| Mailing Fax Number | 3362738038 |
| Enumeration Date | 2009-10-28 |
| Last Update Date | 2009-10-28 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223X0400X |
Dentist Specialization: Orthodontics and Dentofacial Orthopedics |
3338 | PA | Dental Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548664766 | Jerry Kent Clark Jr. | Audiologist | 4611 Otter Ct, Burlington, NC 27215-9076 | 2014-10-17 |
| 1447490792 | Jerry W Clark | Counselor | 470 Bannon St, Sacramento, CA 95811-0204 | 2009-02-26 |
| 1114082872 | Jerry S Clark | Chiropractor | 3325 N University Ave Ste 125, Provo, UT 84604-6615 | 2006-12-23 |
| 1710058284 | Jerry D Clark | Counselor | 1830 Nasa Pkwy Ste 104, Houston, TX 77058-3544 | 2006-11-13 |
| 1639187297 | Jerry Christopher Clark | Massage Therapist | 2360 S Union Ave, Alliance, OH 44601-5079 | 2006-08-03 |
| 1710465919 | Jerry Clark | Behavioral Analyst | 27777 Inkster Rd Ste 100, Farmington Hills, MI 48334-5326 | 2018-07-31 |
| 1497232060 | Jerry Dean Clark | Counselor | 1616 S Gold St Ste 4, Centralia, WA 98531-8930 | 2018-07-25 |
| 1881911261 | Jerry Lee Clark | Social Worker | 201 W Broadway St, Suite A, North Little Rock, AR 72114-5552 | 2010-04-26 |
| 1356521371 | Jerry Lee Clark | Counselor | 112 N Broad St, Rm 821, Phila, PA 19102-1510 | 2007-11-07 |
| 1346280005 | Jerry A Clark | Internal Medicine | 722 N Fairfield Rd, Beavercreek, OH 45434-5918 | 2006-06-08 |
| Street Address |
1115 W FRIENDLY AVE |
| City | GREENSBORO |
| State | NC |
| Zip Code | 27401-1844 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821202433 | Reid M. Clark, Dds | Dentist | 1115 W Friendly Ave, Greensboro, NC 27401-6137 | 2007-05-10 |
| 1972819506 | Brittany P Blue | Dentist | 1115 W Friendly Ave, Greensboro, NC 27401 | 2010-08-20 |
| 1437355567 | Mark Anthony Wilkinson | Dentist | 1115 W Friendly Ave, Greensboro, NC 27401-6137 | 2007-06-25 |
| 1437363025 | Reid Morrow Clark | Dentist | 1115 W Friendly Ave, Greensboro, NC 27401-6137 | 2007-05-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639779655 | Warfair Counseling, Consulting, & Supervision, Pllc | Counselor | 301 South Elm Street, Suite 801, Greensboro, NC 27401 | 2020-10-28 |
| 1225636848 | Alma Lucero Diaz | Registered Nurse | 1121 North Church St, Greensboro, NC 27401 | 2020-10-15 |
| 1447865217 | Rebecca Levy | Marriage & Family Therapist | Cone Health Family Medicine 1125 N Church Street, Greensboro, NC 27401 | 2020-09-09 |
| 1346854304 | Rayna's Home Care, LLC | Registered Nurse | 823 North Elm Street, Greensboro, NC 27401 | 2020-09-06 |
| 1316574718 | Garrett Green | Physician Assistant | 1121 N Church St., Greensboro, NC 27401 | 2020-03-25 |
| 1629635685 | Lauren Robinson Byrd | Anesthesiology | 1200 North Church St, Greensboro, NC 27401 | 2019-05-24 |
| 1285103069 | Shannon Marie Childs Meyerhoff | Occupational Therapist | Guilford County Schools Ec, 134 Franklin Blvd, Greensboro, NC 27401 | 2018-11-21 |
| 1194293241 | Ashley Marie Smith | Nurse Practitioner | 1200 North Elm St, Greensboro, NC 27401 | 2018-11-07 |
| 1285117762 | Anastazia Juszczak Gray | Speech-Language Pathologist | 1131 N. Church St, Greensboro, NC 27401 | 2018-09-11 |
| 1619474012 | Jamie Hannah Rose Aldridge | Psychiatry & Neurology | 1121 N Church Street, Greensboro, NC 27401 | 2018-04-11 |
| Find all providers in zip 27401 | ||||
| Taxonomy Code | 1223X0400X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Orthodontics and Dentofacial Orthopedics |
| That area of dentistry concerned with the supervision, guidance and correction of the growing or mature dentofacial structures, including those conditions that require movement of teeth or correction of malrelationships and malformations of their related structures and the adjustment of relationships between and among teeth and facial bones by the application of forces and/or the stimulation and redirection of functional forces within the craniofacial complex. Major responsibilities of orthodontic practice include the diagnosis, prevention, interception and treatment of all forms of malocclusion of the teeth and associated alterations in their surrounding structures; the design, application and control of functional and corrective appliances; and the guidance of the dentition and its supporting structures to attain and maintain optimum occlusal relations in physiologic and esthetic harmony among facial and cranial structures. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578177952 | Mcmillian Dds and Morrone Dmd, Pa | Dentist | 2301 Battleground Ave, Greensboro, NC 27408-5422 | 2020-09-03 |
| 1487263125 | T Richard Ziehmer Dds Msd Pllc | Dentist | 4016 Battleground Ave Ste H, Greensboro, NC 27410-9800 | 2020-07-29 |
| 1992323901 | M. Avey & Associates Nc PC V | Dentist | 1507 Westover Ter Ste A, Greensboro, NC 27408-7121 | 2020-07-07 |
| 1700326394 | Carrie N Bell | Dentist | 5314 W. Friendly Avenue, Suite B, Greensboro, NC 27410 | 2017-03-01 |
| 1912166034 | Cheryl Mitchell Trentini | Dentist | 2727 Horse Pen Creek Road, Suite 103, Greensboro, NC 27410 | 2008-06-04 |
| 1629262530 | Joseph Richard Steedle | Dentist | 3106 Saint Regis Rd, Greensboro, NC 27408-4409 | 2007-09-04 |
| 1447371182 | Numa Cobb IIi | Dentist | 604 Pasteur Dr Ste A, Greensboro, NC 27403-1145 | 2007-04-02 |
| 1598896946 | Mark William Reynolds | Dentist | 1304 Beaman Pl, Greensboro, NC 27408-8704 | 2007-03-08 |
| 1932124807 | Mark Hamilton Kaley | Dentist | 2510 Oakcrest Ave, Greensboro, NC 27408-4720 | 2006-07-13 |
| 1174509509 | Brian William Bartlett | Dentist | 5314 W Friendly Ave Ste B, Greensboro, NC 27410-4351 | 2005-12-19 |
| Find all providers in GREENSBORO | ||||
| City | GREENSBORO |
| Zip Code | 27401 |
Please comment or provide details below to improve the information on DR. JERRY R CLARK.
| 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.