DR. ALAN DOUGLAS CLARK (NPI# 1619985884) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1619985884 |
| Entity Type | Individual |
| Full Name | DR. ALAN DOUGLAS CLARK |
| Credential | DDS |
| Practice Address |
745 E. Joyce Ste 221 Fayetteville AR 72703 |
| Practice Telephone | 4794431849 |
| Practice Fax Number | 4794432034 |
| Mailing Telephone | 4794431849 |
| Mailing Fax Number | 4794432034 |
| Enumeration Date | 2006-08-04 |
| Last Update Date | 2012-10-26 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
3349 | AR | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AR | 143894608 | 05 | |
| AR | OLD TAX ID # | 870436704 | 01 |
| AR | NEW TAX ID # | 412175658 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114197456 | Alan A Clark | Dentist | 15898 Bush Rd, Nevada City, CA 95959-9201 | 2008-03-03 |
| 1912121955 | Alan E Clark | Perfusionist | 3061 Massasoit Ave, San Diego, CA 92117-2522 | 2007-04-12 |
| 1275689689 | Alan Clark | Optometrist | 644 San Antonio Rd, Mountain View, CA 94040-1304 | 2007-01-26 |
| 1619026119 | Alan R Clark | Physician Assistant | 4601 W Market St, Greensboro, NC 27408 | 2007-01-10 |
| 1659363539 | Alan James Clark | Ophthalmology | 133 Marion Oaks Blvd, Ocala, FL 34473-2211 | 2005-08-17 |
| 1104442300 | Alan Keith Clark | Case Manager/Care Coordinator | 420 Sw 10th St, Oklahoma City, OK 73109-5610 | 2020-06-23 |
| 1366500712 | Alan B. Clark | Psychiatry & Neurology | 240 Central Ave, East Orange, NJ 07018-3313 | 2006-12-05 |
| 1841206109 | Alan E. Clark | Psychologist | 2730 Wilshire Blvd, Santa Monica, CA 90403-4743 | 2006-07-31 |
| 1538196134 | Alan W Clark | Physician Assistant | 1401 S Laventure Rd, Mount Vernon, WA 98274-6033 | 2006-06-27 |
| 1053351254 | Alan S Clark | Emergency Medicine | 1612 S Henderson Blvd, Kilgore, TX 75662-3518 | 2006-06-07 |
| Street Address |
745 E. JOYCE STE 221 |
| City | FAYETTEVILLE |
| State | AR |
| Zip Code | 72703 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982772018 | Bruce Lane Welsh | Dentist | 745 E. Joyce, Suite 221, Fayetteville, AR 72703 | 2006-11-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477154391 | Margaret Sorrells | Pharmacist | 3909 N Mall Ave Attn:pharmacy, Fayetteville, AR 72703 | 2020-11-06 |
| 1497369631 | Justin A Rand | Massage Therapist | 88 W Colt Square Dr, Fayetteville, Ar 72703, Fayetteville, AR 72703 | 2020-09-04 |
| 1235777558 | Washington Regional Medical System | Specialist | 3264 N North Hills Blvd, Fayetteville, AR 72703 | 2019-12-17 |
| 1760024582 | Haley Brooke Thompson | Occupational Therapist | 2474 E Joyce Blvd Ste 2, Null, Fayetteville, AR 72703 | 2019-10-14 |
| 1306492129 | Bhg L, LLC | Clinic/Center | 8 Colt Square Drive, Fayetteville, AR 72703 | 2019-08-16 |
| 1306406269 | Idell Marie Mitchell | Optometrist | Eye Clinic, 1100 N College Ave, Fayetteville, AR 72703 | 2019-06-13 |
| 1821574815 | Toni Myer | Nurse Practitioner | 3 E Appleby Rd Ste 101, Fayetteville, AR 72703 | 2018-07-13 |
| 1306340393 | Josh Kelfer | Student in an Organized Health Care Education/Training Program | 1125 North College Avenue, Fayetteville, AR 72703 | 2018-03-22 |
| 1649726449 | Vantage Point of Nwa | Community/Behavioral Health | 4171 N. Crossover Rd, Fayetteville, AR 72703 | 2016-08-31 |
| 1386097137 | Jason Nordstrom | Speech-Language Pathologist | 2664 N Valencia Ave, Fayetteville, AR 72703 | 2016-07-18 |
| Find all providers in zip 72703 | ||||
| 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 |
|---|---|---|---|---|
| 1346898335 | Chaitanya Joopally Dds Pllc | Dentist | 2050 Skibo Rd. Ste 104, Fayetteville, NC 28314 | 2019-09-03 |
| 1972151439 | Ikenna K Okons | Dentist | 4200 Morganton Rd Ste 304, Fayetteville, NC 28314-1564 | 2019-08-28 |
| 1114488079 | Bianca Kristina Adams | Dentist | 207 Forest Creek Dr, Fayetteville, NC 28303-5496 | 2019-03-25 |
| 1194226506 | Michael E. Carter, Dds, Pllc | Dentist | 1874 N Hunters Rdg Ste 1, Fayetteville, AR 72701-2896 | 2018-02-22 |
| 1760900153 | Elali Alisha Marie Moukwa | Dentist | 1916 Skibo Rd Ste C3, Fayetteville, NC 28314 | 2017-09-06 |
| 1548781107 | Christopher Heard | Dentist | 265 N Jeff Davis Dr Ste 1a, Fayetteville, GA 30214-1668 | 2017-07-03 |
| 1881123305 | Kenneth Boyd Lewis Jr. | Dentist | 4140 Ramsey St Ste 104, Fayetteville, NC 28311-7658 | 2017-06-08 |
| 1518496215 | Van Michael Mcqueen Jr. | Dentist | 640 N Garland Ave # 104, Fayetteville, AR 72701 | 2017-06-06 |
| 1710415229 | Alan Kuo | Dentist | 1400 Walter Reed Rd Ste 200, Fayetteville, NC 28304 | 2017-05-28 |
| 1508304866 | Karan G Mirchandani | Dentist | 4251 Ramsey St Ste 8, Fayetteville, NC 28311-2130 | 2017-02-07 |
| Find all providers in FAYETTEVILLE | ||||
| City | FAYETTEVILLE |
| Zip Code | 72703 |
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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.