DR. ANDREW EDWARD CLARK (NPI# 1992017164) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1992017164 |
| Entity Type | Individual |
| Full Name | DR. ANDREW EDWARD CLARK |
| Credential | DMD |
| Practice Address |
1036-42 Dunn Ave Jacksonville FL 32218-6359 |
| Mailing Address |
13117 Sw 6th Ave Newberry FL 32669-4950 |
| Practice Telephone | 9047149909 |
| Enumeration Date | 2010-07-05 |
| Last Update Date | 2013-01-10 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223X0400X |
Dentist Specialization: Orthodontics and Dentofacial Orthopedics |
DN 19032 | FL | Dental Providers |
| N | 390200000X | Student in an Organized Health Care Education/Training Program | DN 19032 | FL | Student, Health Care |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194288563 | Andrew Byler Clark | Student in an Organized Health Care Education/Training Program | 200 Jeanette Lancaster Way, Charlottesville, VA 22903-3388 | 2019-04-11 |
| 1588156509 | Andrew Jeffrey Clark | Chiropractor | 6304 College Blvd, Overland Park, KS 66211-1506 | 2018-06-05 |
| 1518373257 | Andrew Clark | Case Manager/Care Coordinator | 100 Barberry Dr, Knoxville, TN 37912 | 2014-07-02 |
| 1316215528 | Andrew J Clark | Counselor | 1219 Oak Knoll Rd, Santa Maria, CA 93455-4303 | 2011-12-02 |
| 1760683635 | Andrew Clark | Student in an Organized Health Care Education/Training Program | 109 Pine Knoll Dr, 347, Ridgeland, MS 39157-1350 | 2007-05-30 |
| 1912988635 | Andrew Robert Clark | Family Medicine | 5123 4th Avenue Cir E, Bradenton, FL 34208-5620 | 2005-11-09 |
| 1093374936 | Andrew Elton Clark | Spec/Tech, Pathology | 6201 Harry Hines Blvd, Dallas, TX 75390-0001 | 2019-06-12 |
| 1679034508 | Andrew Jeffrey Clark | Student in an Organized Health Care Education/Training Program | 530 S Jackson St, Louisville, KY 40202-1675 | 2019-03-25 |
| 1447745336 | Andrew Clark | Student in an Organized Health Care Education/Training Program | 1450 San Pablo St Fl 4, Los Angeles, CA 90033-5331 | 2018-06-25 |
| 1609365352 | Andrew Thomas Clark | Registered Nurse | 54 New Hyde Park Rd, Garden City, NY 11530 | 2018-05-08 |
| Street Address |
1036-42 DUNN AVE |
| City | JACKSONVILLE |
| State | FL |
| Zip Code | 32218-6359 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316320369 | Diana N. Kinyua | Dentist | 1036-42 Dunn Ave, Jacksonville, FL 32218-6359 | 2015-07-08 |
| 1235551458 | Bryce E. Gabler | Dentist | 1036-42 Dunn Ave, Jacksonville, FL 32218-6359 | 2014-01-07 |
| 1114367471 | Donald Van | Dentist | 1036-42 Dunn Ave, Jacksonville, FL 32218-6359 | 2013-07-02 |
| 1578823985 | Derrick L Mitchell | Dentist | 1036-42 Dunn Ave, Jacksonville, FL 32218-6359 | 2012-05-18 |
| 1518255561 | Derek R. Espino | Dentist | 1036-42 Dunn Ave, Jacksonville, FL 32218-6359 | 2011-07-12 |
| 1912291071 | Joshua J Estes | Dentist | 1036-42 Dunn Ave, Jacksonville, FL 32218-6359 | 2011-06-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629684170 | Damon Lamar Baker | Nurse Practitioner | 12533 Sampson Rd, Jacksonville, Fl, FL 32218 | 2020-09-21 |
| 1578199303 | First Coast Health Ventures, LLC | Skilled Nursing Facility | 15480 Max Leggett Parkway, Jacksonville, FL 32218 | 2020-03-12 |
| 1932679594 | Alaina Rachelle Stanley | Counselor | 11683 Spring Board Dr, Jacksonville, FL 32218 | 2018-11-27 |
| 1508345133 | War Cry Ministry Inc | Counselor | 435 Eric Ave, Jacksonville, FL 32218 | 2018-08-14 |
| 1285111484 | St Vincent's Full Service Urgent Care, LLC | Clinic/Center | 15510 Max Leggett Parkway, Ste A, Jacksonville, FL 32218 | 2018-07-20 |
| 1427544501 | Derrick Roberts | Behavioral Analyst | 11302 Forestdale Rd, Jacksonville, FL 32218 | 2018-07-02 |
| 1215420229 | Companion & Compassion LLC | Home Health | 856 Poydras Ln W, Jacksonville, FL 32218 | 2018-06-13 |
| 1952894784 | Michael Alexander Aaro | Dentist | 1840 Dunn Ave Ste 3, Jacksonville, FL 32218 | 2018-06-06 |
| 1235629445 | Melissa C Moree | Counselor | 13453 Main St. North, Suite 104, Jacksonville, FL 32218 | 2018-05-14 |
| 1861900896 | Sheila Nowlin | Physical Therapist | 1034 Dunn Ave, Jacksonville, FL 32218 | 2018-01-11 |
| Find all providers in zip 32218 | ||||
| Taxonomy Code | 1223X0400X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Orthodontics and Dentofacial Orthopedics |
| That area of dentistry concerned with the supervision, guidance and correction of the growing or mature dentofacial structures, including those conditions that require movement of teeth or correction of malrelationships and malformations of their related structures and the adjustment of relationships between and among teeth and facial bones by the application of forces and/or the stimulation and redirection of functional forces within the craniofacial complex. Major responsibilities of orthodontic practice include the diagnosis, prevention, interception and treatment of all forms of malocclusion of the teeth and associated alterations in their surrounding structures; the design, application and control of functional and corrective appliances; and the guidance of the dentition and its supporting structures to attain and maintain optimum occlusal relations in physiologic and esthetic harmony among facial and cranial structures. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609408574 | Ortho 99 Plus 1 | Dentist | 7410 Merrill Road, Suite 2, Jacksonville, FL 32277 | 2020-02-10 |
| 1518434398 | Michelle Lien Clinton Munoz | Dentist | 1917 Reveille Cir, Jacksonville, AR 72076-9157 | 2018-10-30 |
| 1225543408 | Fateh Arslan | Dentist | 9745 Touchton Rd Unit 1725, Jacksonville, FL 32246-9200 | 2017-12-09 |
| 1477087815 | Naila Ortega | Dentist | 984 Chapeltown Circle N, Jacksonville, FL 32225 | 2017-04-12 |
| 1184047888 | Rodeffer, Garner, Minor and Mokris Orthodontics | Dentist | 2363 Dunn Avenue, Jacksonville, FL 32218 | 2014-01-31 |
| 1326322678 | Jossette Vo, D.m.d., P.a. | Dentist | 6339 -1 Argyle Forest Blvd, 1, Jacksonville, FL 32244-6666 | 2011-10-05 |
| 1598995227 | Lily Ayn Workman | Dentist | 9727 Touchton Rd, Apt 909, Jacksonville, FL 32246-8229 | 2009-07-15 |
| 1396984878 | Terry Tippin, D.m.d., P.l.c. | Dentist | 2800 University Blvd. North, Jacksonville, FL 32211-3394 | 2009-02-06 |
| 1992966816 | Jason M Rice | Dentist | 620 Commerce Center Dr Unit 155, Jacksonville, FL 32225-8803 | 2008-06-23 |
| 1881866861 | Michael Glenn Beard | Dentist | 2005 E Rusk St, Jacksonville, TX 75766-9059 | 2008-03-30 |
| Find all providers in JACKSONVILLE | ||||
| City | JACKSONVILLE |
| Zip Code | 32218 |
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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.