CLARK GENERAL DENTISTRY CENTER, P.C. (NPI# 1740543776) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1740543776 |
| Entity Type | Organization |
| Organization Name | CLARK GENERAL DENTISTRY CENTER, P.C. |
| Practice Address |
1918 Forsyth St Macon GA 31201-1144 |
| Practice Telephone | 4787460046 |
| Practice Fax Number | 4787460970 |
| Mailing Telephone | 4787460046 |
| Mailing Fax Number | 4787460970 |
| Enumeration Date | 2012-06-25 |
| Last Update Date | 2012-06-25 |
| Authorized Official Name | DR. RODNEY KEITH CLARK (PRESIDENT) |
| Authorized Official Telephone | 4787460046 |
| Authorized Official Credential | DDS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 122300000X | Dentist | 12507 | GA | Dental Providers |
| Street Address |
1918 FORSYTH ST |
| City | MACON |
| State | GA |
| Zip Code | 31201-1144 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639666340 | Yasameen Emad Muzahim | Internal Medicine | 777 Hemlock Street, Msc 165, Macon, GA 31201 | 2018-04-18 |
| 1952819419 | Putnam Dialysis LLC | Clinic/Center | 657 Hemlock Street, Suite 200, Macon, GA 31201 | 2018-01-18 |
| 1730604331 | Graham Arthur Mercier | Surgery | 169 Ashley Ave., Room 202 Main Hospital Msc 333, Charleston, SC 31201 | 2017-08-04 |
| 1376075705 | Diamond Jude | Internal Medicine | 777 Hemlock Street Msc #104, Macon, GA 31201 | 2017-04-03 |
| 1174055263 | Carol Roobin Bashuk | Hearing Instrument Specialist | 634 First Street, Macon, GA 31201 | 2017-03-29 |
| 1144752411 | Hubert Pare | Student in an Organized Health Care Education/Training Program | 777 Hemlock Street, Msc# 165, Macon, GA 31201 | 2017-03-28 |
| 1548613789 | Michael Daugherty | Counselor | 1873 Hardeman Ave, Suite 1, Macon, GA 31201 | 2016-07-22 |
| 1316317993 | 4front Healthcare of Middle Georgia, LLC | Hospice Care, Community Based | 682 1st St, Macon, GA 31201 | 2015-09-25 |
| 1881073054 | Andrew Lee Drahos | Surgery | 777 Hemlock St # 140, Macon, GA 31201 | 2015-05-21 |
| 1720474158 | April Nicole Colley | Nurse Practitioner | 1014 Forsyth Street, Macon, GA 31201 | 2015-04-13 |
| Find all providers in zip 31201 | ||||
| Taxonomy Code | 122300000X |
| Grouping | Dental Providers |
| Classification | Dentist |
| A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598267239 | Folarera Olanike Ajose-adeogun | Dentist | 5005 Riverside Dr Unit A, Macon, GA 31210-1121 | 2018-03-07 |
| 1235683285 | John Felix Mash Jr. | Dentist | 128 Wolf Creek Dr N, Macon, GA 31210-9001 | 2016-08-08 |
| 1134568777 | John Norman Bowman Sr. | Dentist | 760 Tufthunter, Macon, GA 31210 | 2013-06-17 |
| 1801134135 | Valerie W Ambrose | Dentist | 160 Pierce Ave, Macon, GA 31204-2871 | 2013-01-22 |
| 1528314853 | Harvey Steven Zion | Dentist | 3300 Macon Tech Dr, Bldg J, Macon, GA 31206-3628 | 2012-07-24 |
| 1134441652 | Loretto Madeleine Grier-cudjoe | Dentist | 1625 Jeffersonville Rd, Macon, GA 31217-4342 | 2010-02-25 |
| 1770741704 | Charles Edward Smaha | Dentist | 151 Pierce Ave, Macon, GA 31204-2821 | 2008-05-27 |
| 1447458856 | Paul Jason Mann | Dentist | 225 North Macon St., Macon, GA 31210 | 2007-07-06 |
| 1447451612 | Larry Edward Landers | Dentist | 155 College St, Suite 2, Macon, GA 31201-7206 | 2007-05-29 |
| 1033237540 | Jonathan P Griggs | Dentist | 4128 Arkwright Rd, Suite A, Macon, GA 31210-1707 | 2007-03-26 |
| Find all providers in MACON | ||||
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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.