DR. JEFFREY MICHAEL CLARK (NPI# 1891989158) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1891989158 |
| Entity Type | Individual |
| Full Name | DR. JEFFREY MICHAEL CLARK |
| Credential | DMD |
| Practice Address |
10429 Lagrima De Oro Rd Ne Albuquerque NM 87111 |
| Practice Telephone | 5052978630 |
| Mailing Telephone | 5052918630 |
| Enumeration Date | 2007-08-30 |
| Last Update Date | 2017-02-21 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223E0200X |
Dentist Specialization: Endodontics |
DD4484 | NM | Dental Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619505914 | Jeffrey Scott Clark | Counselor | 402 E Yakima Ave Ste 800-c, Yakima, WA 98901-5407 | 2020-03-31 |
| 1063805844 | Jeffrey Clark | Specialist/Technologist | 315 Reber Ave, Lancaster, OH 43130-1761 | 2015-03-18 |
| 1134535248 | Jeffrey Clark | Hearing Instrument Specialist | 123 E Mondamin St, Minooka, IL 60447-9896 | 2014-07-09 |
| 1174942353 | Jeffrey Clark | Pediatrics | 9576 Hwy 70, Department of Pediatrics, Minocqua, WI 54548 | 2014-04-15 |
| 1881958767 | Jeffrey Kenneth Clark | Pharmacist | 12850 E Montview Blvd Ste C238, Aurora, CO 80045-2605 | 2012-06-26 |
| 1912285495 | Jeffrey S Clark | Chiropractor | 203 Railroad St Ste 3c, Buda, TX 78610-3437 | 2011-08-01 |
| 1003100934 | Jeffrey Paul Clark | Dentist | 1403 N Loop 336 W, Conroe, TX 77304-3503 | 2011-06-08 |
| 1942520044 | Jeffrey B Clark | Dentist | 2133 Belcourt Avenue, Nashville, TN 37212-3503 | 2010-06-11 |
| 1730405333 | Jeffrey Clark | Pharmacist | 611 N Perry St, Bldg #2, Suite 202, Spokane, WA 99202-5011 | 2010-04-08 |
| 1851411755 | Jeffrey Paul Clark | Family Medicine | 652 N 1180 E, Orem, UT 84097-5467 | 2007-04-02 |
| Street Address |
10429 LAGRIMA DE ORO RD NE |
| City | ALBUQUERQUE |
| State | NM |
| Zip Code | 87111 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417438110 | Dehlen LLC | Counselor | 11000 Spain Rd Ne, Building E, Albuquerque, NM 87111 | 2018-08-22 |
| 1003313008 | Jessika Junick | Nurse Practitioner | 3825 Eubank Blvd Ne Ste A, Albuquerque, NM 87111 | 2018-04-07 |
| 1881113454 | Hayley Aragon-bell | Day Training/Habilitation Specialist | 3732 Mount Rainier Dr. Ne, Albuquerque, NM 87111 | 2017-09-14 |
| 1750803326 | Sarah Mckenzie Ochoa | Day Training/Habilitation Specialist | 3916 Garcia St Ne, Albuquerque, NM 87111 | 2017-07-14 |
| 1285179549 | Family Dental Health Care | Dentist | 4550 Eubank Blvd, Suite 203, Albuquerque, NM 87111 | 2016-12-22 |
| 1871036202 | Shobha Jagannath | Nurse Practitioner | 10700 Academy Rd Ne Apt 216, Albuquerque, NM 87111 | 2016-12-03 |
| 1508319310 | Mariana Boitano | Licensed Practical Nurse | 5400 Gibson Blvd., Albuquerque, NM 87111 | 2016-07-28 |
| 1184011082 | Adam Halpern | Specialist/Technologist | 4204 Parsifal St, Albuquerque, NM 87111 | 2015-04-20 |
| 1083015770 | Cvs Pharmacy | Public Health or Welfare | 5516 Camino Arbustos Ne, Albuquerque, NM 87111 | 2014-09-12 |
| 1508276973 | Stephanie Gonzales | Physician Assistant | 12241 Academy Rd Ne Ste 204, Albuquerque, NM 87111 | 2014-05-06 |
| Find all providers in zip 87111 | ||||
| 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 |
|---|---|---|---|---|
| 1669024840 | Robert Hochberg, Dds, LLC | Dentist | 7520 Montgomery Blvd Ne Ste B, Building C, Albuquerque, NM 87109-1521 | 2019-07-09 |
| 1922586262 | Clark Endodontics LLC | Dentist | 7520 Montgomery Blvd Ne Bldg E1, Albuquerque, NM 87109 | 2018-07-30 |
| 1003220203 | Shane Thomas Clark | Dentist | 2800 Coors Blvd Nw, Albuquerque, NM 87120-1204 | 2014-06-16 |
| 1780811984 | Ryan Hastiin Wilson | Dentist | 6810 Menaul Blvd Ne Ste B, Albuquerque, NM 87110 | 2009-06-15 |
| 1356508931 | David Lloyd Hadley | Dentist | 10409 Montgomery Pkwy Ne Ste 100, Albuquerque, NM 87111-3862 | 2008-05-21 |
| 1760671705 | New Mexico Endodontic Specialists, PC | Dentist | 10151 Montgomery Blvd Ne Ste 2b, Albuquerque, NM 87111-3664 | 2007-10-16 |
| 1134334907 | Colin Simeon Shaw | Dentist | 4620 Jefferson Ln Ne Ste C, Albuquerque, NM 87109-2120 | 2007-05-14 |
| 1063493427 | Advanced Endodontics | Dentist | 7520 Montgomery Blvd, E1, Albuquerque, NM 87109 | 2005-11-10 |
| 1063940237 | John Steffensen | Dentist | 2800 Coors Blvd Nw Ste A, Albuquerque, NM 87120-1204 | 2017-05-31 |
| 1568854339 | Papworth Endodontics | Dentist | 10151 Montgomery Blvd Ne, Suite 1-c, Albuquerque, NM 87111-3670 | 2015-03-03 |
| Find all providers in ALBUQUERQUE | ||||
| City | ALBUQUERQUE |
| Zip Code | 87111 |
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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.