CLARK & OTERO DDS PLLC (NPI# 1710384938) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1710384938 |
| Entity Type | Organization |
| Organization Name | CLARK & OTERO DDS PLLC |
| Other Organization Name | OAK GROVE DENTAL |
| Practice Address |
103 Ganyard Farm Way Durham NC 27703-6230 |
| Mailing Address |
103 Ganyard Farm Way Durham NC 27703 |
| Practice Telephone | 9199572444 |
| Practice Fax Number | 8885059592 |
| Mailing Telephone | (919) 597-2444 |
| Mailing Fax Number | 8885059592 |
| Enumeration Date | 2014-12-03 |
| Last Update Date | 2017-10-27 |
| Authorized Official Name | BEBE GUNTER JACKSON (MANAGER) |
| Authorized Official Telephone | 9108632377 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 122300000X | Dentist | NC | Dental Providers | |
| N | 1223G0001X |
Dentist Specialization: General Practice |
9387 | NC | Dental Providers |
| Y | 1223G0001X |
Dentist Specialization: General Practice |
NC | Dental Providers |
| Other Name | Type Code |
|---|---|
| Oak Grove Dental | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790930030 | Clark & Otero Dds Pllc | Dentist | 103 Ganyard Farm Way, Durham, NC 27703-6230 | 2008-12-01 |
| Street Address |
103 GANYARD FARM WAY |
| City | DURHAM |
| State | NC |
| Zip Code | 27703-6230 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497959712 | Erika M Graham | Dentist | 103 Ganyard Farm Way, Durham, NC 27703-6230 | 2007-06-12 |
| 1790930030 | Clark & Otero Dds Pllc | Dentist | 103 Ganyard Farm Way, Durham, NC 27703-6230 | 2008-12-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285235218 | Joseph Omalemigbo Abgateyiniro | Durable Medical Equipment & Medical Supplies | 1810 Shiva Court, Durham, NC 27703 | 2020-11-05 |
| 1326654278 | Step By Step In Home Care LLC | Home Health | Imperial Business Park, 4819 Emperor Blvd Suite 400, Durham, NC 27703 | 2020-09-16 |
| 1023598463 | Impact Therapy Services | Speech-Language Pathologist | 6 Winnabow Court, Durham, NC 27703 | 2018-08-15 |
| 1326536327 | Renal Treatment Centers - Mid-atlantic, Inc. | Clinic/Center | 1100 N Miami Blvd Ste 500a, Durham, NC 27703 | 2018-04-25 |
| 1033621719 | Duke University | Preventive Medicine | 4825 Creekstone Drive, Suite 105, Durham, NC 27703 | 2017-11-02 |
| 1023535564 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 3725 Wake Forest Hwy, Durham, NC 27703 | 2017-08-25 |
| 1487194171 | Shivani L. Chudasama | Social Worker | 5475 Lumley Rd Ste 103, Durham, NC 27703 | 2017-03-01 |
| 1356886030 | Rgh Enterprises, Inc. | Durable Medical Equipment & Medical Supplies | 4234 Surles Court, Suite 100, Durham, NC 27703 | 2017-01-04 |
| 1780032821 | Victory Speech Therapy Services, Pllc | Speech-Language Pathologist | 1533 Ellis Rd., Apt J208, Durham, NC 27703 | 2016-05-31 |
| 1124422373 | Helene Azimbi Fonebi | Pharmacist | 8 Gandhi Dr, Durham, NC 27703 | 2014-10-17 |
| Find all providers in zip 27703 | ||||
| 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 |
|---|---|---|---|---|
| 1982220356 | Anne Kathryn Dorsey | Dentist | 1922 Bivins St, Durham, NC 27707-1402 | 2020-06-22 |
| 1164048625 | Aman Masoomi | Dentist | 1205 Pondfield Way, Durham, NC 27713-7609 | 2020-06-21 |
| 1801417878 | Logan Alexander Eaker | Dentist | 7 Coach Ter, Durham, NC 27713-6094 | 2020-04-30 |
| 1649820093 | Oyegunwa and Associates II, Pllc | Dentist | 3219 Watkins Rd Ste 103, Durham, NC 27707-3331 | 2019-09-18 |
| 1568956084 | Laurent Pilon | Dentist | 2741 Campus Walk Ave Bldg 300, Durham, NC 27705-8878 | 2018-06-18 |
| 1245723139 | Devang Ashokbhai Patel | Dentist | 2609 N Duke St Ste 618, Durham, NC 27704 | 2018-06-14 |
| 1083113948 | Deepika Verma Dmd Pllc | Dentist | 2003 E Nc Highway 54 Ste A, Durham, NC 27713-2483 | 2018-02-06 |
| 1447765094 | Alterman Dhillon and Associates | Dentist | 202 W Nc Hwy 54, Suite 201, Durham, NC 27713 | 2017-12-05 |
| 1295196418 | Dr Li Qian Dds Pllc | Dentist | 6104 Fayetteville Rd Ste 106, Durham, NC 27713-6283 | 2016-03-15 |
| 1841688033 | Jonathan Joseph Puza | Dentist | 3608 University Dr Ste 104, Durham, NC 27707-6260 | 2014-12-23 |
| Find all providers in DURHAM | ||||
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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.