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DR. CHARLES CLARK
NPI 1346133287
Dentist - Pediatric Dentistry in East Boston, MA

Active since May 30, 2025
20 MAVERICK SQ, EAST BOSTON, MA 02128(617) 568-4464 Get Directions Write a Review

NPPES record last updated: May 30, 2025. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Dr. Charles Clark NPPES

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

DR. CHARLES CLARK (NPI 1346133287) is an individual pediatric dentistry provider in East Boston, Massachusetts, licensed in Massachusetts (1857730) and active in the NPI registry since May 2025.

NPPES Registry Identity

NPI1346133287
Entity TypeIndividualMale
Primary Taxonomy1223P0221X
Provider Legal NameDR. CHARLES CLARK
Location Address20 MAVERICK SQEast Boston, MA 02128-2335
Mailing Address1282 Boylston St Unit 1023Boston, MA 02215-4462
Phone(617) 568-4464
Sole ProprietorYes
Enumeration DateMay 30, 2025
NPPES CertifiedMay 30, 2025
✔ NPI 1346133287 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · Pediatric DentistryDental Providers
Taxonomy Code1223P0221X
License✔ Licensed in MA · 1857730
Definition

An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs.

20 MAVERICK SQ, East Boston, MA 02128
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Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MAVERICK SPECIALTY RETAIL PHARMACY
Pharmacy (Specialty Pharmacy)
20 MAVERICK SQ
EAST BOSTON, MA 02128
Suffolk County (617) 568-4781
DR. SUMATI BHALLA DDS
Dentist (General Practice)
20 MAVERICK SQ
EAST BOSTON, MA 02128
Suffolk County (617) 569-5800
YUEQI LI
Counselor (School)
20 MAVERICK SQ
EAST BOSTON, MA 02128
Suffolk County (617) 569-5800
KATHERINE HENAO-MARTINEZ CNP
Nurse Practitioner (Family)
20 MAVERICK SQ
EAST BOSTON, MA 02128
Suffolk County (617) 569-5800
MR. JOSE LUIS DE RAMON III
Psychologist (Counseling)
20 MAVERICK SQ
BOSTON, MA 02128
Suffolk County (305) 305-5140
LARISSA HEIDEMANN PAGANINI DMD
Dentist (General Practice)
20 MAVERICK SQ
EAST BOSTON, MA 02128
Suffolk County (617) 569-5800
RICHARD JOE HO O.D.
Optometrist
20 MAVERICK SQ
EAST BOSTON, MA 02128
Suffolk County (617) 568-4474
CARLOS ECHEVARRIA MALDONADO PHARMD
Pharmacist
20 MAVERICK SQ
EAST BOSTON, MA 02128
Suffolk County (617) 569-5800

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 Charles Clark's NPI number?

The NPI number for Charles Clark is 1346133287. It was assigned to this individual provider in the NPPES registry on May 30, 2025.

Where is Charles Clark located?

Charles Clark practices at 20 Maverick Sq, East Boston, MA 02128. The listed phone number is (617) 568-4464.

What is Charles Clark's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Pediatric Dentistry, with taxonomy code 1223P0221X.

When was this NPI record last updated?

The NPPES record for Charles Clark was last updated on May 30, 2025. NPI Profile syncs with the weekly NPPES data releases published by CMS.