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DENTAL SOURCE OF CALIFORNIA
NPI 1083362537
Clinic/Center - Dental in Folsom, CA

Active since March 14, 2022
25005 BLUE RAVINE RD STE 100, FOLSOM, CA 95630(916) 600-3719 Get Directions Write a Review

NPPES record last updated: May 16, 2022. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Table of Contents

  1. NPI Profile Information
  2. Primary Taxonomy
  3. Authorized Official
  4. Other Providers Same Location
  5. Frequently Asked Questions
  • Organization
  • Clinic/Center
  • Dental

About DENTAL SOURCE OF CALIFORNIA

This page provides the complete NPI Profile along with additional information for Dental Source Of California, a provider established in Folsom, California operating as a Clinic/center, focusing in dental . The healthcare provider is registered in the NPI registry with number 1083362537 assigned on March 2022. The practitioner's primary taxonomy code is 261QD0000X. The provider is registered as an organization and their NPI record was last updated 4 years ago. The provider's is doing business as Dental Source Of California. The authorized official of this NPI record is Dr. Donald Clarke Dds (President Of Corporation)

NPI
1083362537 Verify this NPI
Provider Legal Name
DONALD E. CLARKE, D.D.S., INC.
Other Organization Name
DENTAL SOURCE OF CALIFORNIA
Other Name Type
Doing Business As (3)
Entity Type
Organization
Location Address
25005 BLUE RAVINE RD STE 100 FOLSOM, CA 95630
Location Phone
(916) 600-3719
Mailing Address
3901 MARCONI AVE SACRAMENTO, CA 95821
Mailing Phone
(916) 487-0117
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
03-14-2022
Last Update Date
05-16-2022
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Location Map

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Clinic/Center Dental

Taxonomy Code
261QD0000X
Type
Ambulatory Health Care Facilities

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

DR. DONALD CLARKE DDS

Authorized Official Title
PRESIDENT OF CORPORATION
Authorized Official Phone
(916) 487-0117

Reviews for DENTAL SOURCE OF CALIFORNIA

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Other Providers at the Same Location


The following 2 providers are registered at the same or a nearby location.

MANTENA DENTAL CORPORTATION
Dentist (General Practice)
25005 BLUE RAVINE RD STE 100
FOLSOM, CA 95630
Sacramento County (916) 984-8050
DR. DONALD CLARKE D.D.S.
Dentist (General Practice)
25005 BLUE RAVINE RD STE 100
FOLSOM, CA 95630
Sacramento County (916) 984-8050

Frequently Asked Questions

What is DONALD E. CLARKE, D.D.S., INC.'s NPI number?

The NPI number assigned to this healthcare provider is 1083362537, enumerated as an "organization" on March 14, 2022.

Where is the provider located?

The provider is located at 25005 BLUE RAVINE RD STE 100 FOLSOM, CA 95630 and the phone number is (916) 600-3719.

What is the provider's specialty?

Clinic/Center with taxonomy code 261QD0000X and a focus in Dental.