KENDRA NICOLE CLARK (NPI# 1831738087) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1831738087 |
| Entity Type | Individual |
| Full Name | KENDRA NICOLE CLARK |
| Credential | DMD |
| Practice Address |
3880 Hulen St Ste 310 Fort Worth TX 76107-7274 |
| Mailing Address |
2225 Marilla St Apt 4310 Dallas TX 75201-5959 |
| Practice Telephone | 8177377668 |
| Mailing Telephone | 6012134389 |
| Enumeration Date | 2020-01-04 |
| Last Update Date | 2020-10-28 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 122300000X | Dentist | 34365 | TX | Dental Providers |
| N | 122300000X | Dentist | 3992-18 | MS | Dental Providers |
| Y | 1223E0200X |
Dentist Specialization: Endodontics |
34365 | TX | Dental Providers |
| N | 1223E0200X |
Dentist Specialization: Endodontics |
3992-18 | MS | Dental Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 2650 Beach Blvd, Biloxi, MS 395314517 | 2282071581 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821284787 | Kendra Marie Clark | Physician Assistant | 7782 E Fledgling Dr, Scottsdale, AZ 85255-7716 | 2007-09-24 |
| 1831661958 | Kendra Clark | Case Manager/Care Coordinator | 455 E Main St, East Dundee, IL 60118-1529 | 2018-12-31 |
| 1942590005 | Kendra E. Clark | Case Manager/Care Coordinator | 2600 E 18th St, Cheyenne, WY 82001-5511 | 2011-04-11 |
| 1457491870 | Kendra M Clark | Dietitian, Registered | 501 S Union Ave, Food and Nutrition Department, Havre De Grace, MD 21078-3409 | 2007-02-07 |
| Street Address |
3880 HULEN ST STE 310 |
| City | FORT WORTH |
| State | TX |
| Zip Code | 76107-7274 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558591511 | Christopher Dj Yelton | Dentist | 3880 Hulen St Ste 310, Fort Worth, TX 76107-7274 | 2009-07-23 |
| 1831756576 | Essential Endodontics Pa | Dentist | 3880 Hulen St Ste 310, Fort Worth, TX 76107-7274 | 2019-05-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629683602 | Renovo Wound and Hyperbarics Pllc | Emergency Medicine | 5668 Edwards Ranch Road, Suite 101, Fort Worth, TX 76107 | 2020-09-15 |
| 1669085437 | Ryan Bourgeois | Nurse Practitioner | 2917 Crocket Street, Fort Worth, TX 76107 | 2020-08-31 |
| 1053920546 | Christa Marie Widjaja | Optometrist | 1700 Montgomery St, Fort Worth, TX 76107 | 2020-07-30 |
| 1093351355 | Raymond Iannone | Pharmacist | 850 Montgomery St, Suite #310, Fort Worth, TX 76107 | 2019-11-21 |
| 1053963744 | Cumulus Injury Resolution, Inc. | Chiropractor | 4936 Byers Avenue, Fort Worth, TX 76107 | 2019-07-12 |
| 1770135576 | Shadia Osakwe | Physician Assistant | 855 Montgomery Street, Pediatric Clinic, Fort Worth, TX 76107 | 2019-07-11 |
| 1568945442 | Sachin P Patel | Physical Therapist | 4825 Wellesley St, Fort Worth, TX 76107 | 2018-09-07 |
| 1023594025 | Ftw Pharmacy Services Inc | Durable Medical Equipment & Medical Supplies | 2912 W 6th St Ste 150, Fort Worth, TX 76107 | 2018-07-13 |
| 1669974325 | Helen Williamson Elliott | Counselor | 1751 River Run #217, Fort Worth, TX 76107 | 2018-03-08 |
| 1487156931 | Pelvic Neuromonitoring Pllc | Electrodiagnostic Medicine | 111 Boland St #211, Ft Worth, TX 76107 | 2018-03-01 |
| Find all providers in zip 76107 | ||||
| Taxonomy Code | 1223E0200X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Endodontics |
| The branch of dentistry that is concerned with the morphology, physiology and pathology of the human dental pulp and periradicular tissues. Its study and practice encompass the basic and clinical sciences including biology of the normal pulp, the etiology, diagnosis, prevention and treatment of diseases and injuries of the pulp and associated periradicular conditions. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164873204 | Yagnik Patel | Dentist | 3821 Camp Bowie Blvd, Fort Worth, TX 76107-3355 | 2016-06-30 |
| 1083979462 | Fort Worth Endodontics | Dentist | 4545 Bellaire Dr S Ste 8, Fort Worth, TX 76109-1811 | 2012-07-11 |
| 1528323060 | Kayla Tavares | Dentist | 5540 Sycamore School Rd Ste 336, Fort Worth, TX 76123-3061 | 2012-07-11 |
| 1558591511 | Christopher Dj Yelton | Dentist | 3880 Hulen St Ste 310, Fort Worth, TX 76107-7274 | 2009-07-23 |
| 1962646257 | Network Provider Associates, P.C. | Dentist | 12420 Timberland Blvd, Ste 416, Fort Worth, TX 76244-5230 | 2009-04-30 |
| 1396949632 | Ray Cooke Gillespie | Dentist | 6700 Harris Pkwy, Fort Worth, TX 76132-4104 | 2007-06-12 |
| 1588719124 | Pei Kang | Dentist | 5310 N Tarrant Pkwy Ste 104, Fort Worth, TX 76244-5386 | 2007-01-24 |
| 1356346159 | Warren Hunter Marrow | Dentist | 1550 W Rosedale St, Ste 510, Fort Worth, TX 76104-7409 | 2005-06-17 |
| 1972508224 | Allen Phillip Schuster | Dentist | 1112 S Lake St, Fort Worth, TX 76104-4309 | 2005-06-14 |
| 1811515182 | Kayla Tavares, Dds, Pllc | Dentist | 5540 Sycamore School Rd Ste 336, Fort Worth, TX 76123-3061 | 2020-07-13 |
| Find all providers in FORT WORTH | ||||
| City | FORT WORTH |
| Zip Code | 76107 |
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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.