DR. THEODORE GLENN CLARK DDS
NPI 1144321936
Dentist in Winston-salem, NC

Q: What is Theodore Clark's NPI number?

The NPI number for Theodore Clark is 1144321936. It was assigned to this individual provider in the NPPES registry on September 26, 2006.

Q: What is Theodore Clark's specialty?

The primary specialty registered for this NPI is Dentist with taxonomy code 122300000X.

Q: When was this NPI record last updated?

The NPPES record for Theodore Clark was last updated on July 8, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since September 26, 2006

3165 MAPLEWOOD AVENUE, WINSTON-SALEM, NC 27103(336) 765-8358(336) 774-1063 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: August 16, 2026.

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About Dr. Theodore Glenn Clark Dds NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. THEODORE GLENN CLARK DDS (NPI 1144321936) is an individual dentist in Winston-salem, North Carolina, licensed in North Carolina (6127) and active in the NPI registry since September 2006.

NPPES Registry Identity

NPI1144321936

Entity TypeIndividualMale

Primary Taxonomy122300000X

Provider Legal NameDR. THEODORE GLENN CLARKCredential: DDS

Location Address3165 MAPLEWOOD AVENUEWinston-salem, NC 27103

Mailing Address3165 Maplewood AvenueWinston-salem, NC 27103 · (336) 765-8358 · Fax (336) 774-1063

Phone(336) 765-8358

Fax(336) 774-1063

Sole ProprietorNo

Enumeration DateSeptember 26, 2006

Last NPPES UpdateJuly 8, 2007

✔ NPI 1144321936 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentistDental Providers

Taxonomy Code122300000X

License✔ Licensed in NC · 6127

Definition

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.

3165 MAPLEWOOD AVENUE, Winston-salem, NC 27103

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Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Theodore Clark's NPI number?

The NPI number for Theodore Clark is 1144321936. It was assigned to this individual provider in the NPPES registry on September 26, 2006.

Where is Theodore Clark located?

Theodore Clark practices at 3165 Maplewood Avenue, Winston-Salem, NC 27103. The listed phone number is (336) 765-8358.

What is Theodore Clark's specialty?

The primary specialty registered for this NPI is Dentist with taxonomy code 122300000X.

When was this NPI record last updated?

The NPPES record for Theodore Clark was last updated on July 8, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.