DR. JERRY R CLARK DDS, MS
NPI 1619203551
Dentist - Orthodontics and Dentofacial Orthopedics in Greensboro, NC

Active since October 28, 2009
1115 W FRIENDLY AVE, GREENSBORO, NC 27401(336) 273-2528(336) 273-8038 Get Directions Write a Review

NPPES record last updated: October 28, 2009. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Dr. Jerry R Clark Dds, Ms NPPES

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

DR. JERRY R CLARK DDS, MS (NPI 1619203551) is an individual orthodontics and dentofacial orthopedics provider in Greensboro, North Carolina, licensed in Pennsylvania (3338) and active in the NPI registry since October 2009.

NPPES Registry Identity

NPI1619203551
Entity TypeIndividualMale
Primary Taxonomy1223X0400X
Provider Legal NameDR. JERRY R CLARKCredential: DDS, MS
Location Address1115 W FRIENDLY AVEGreensboro, NC 27401-1844
Mailing Address1115 W Friendly AveGreensboro, NC 27401-1844 · (336) 273-2528 · Fax (336) 273-8038
Fax(336) 273-8038
Sole ProprietorYes
Enumeration DateOctober 28, 2009
NPI 1619203551 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyDentist · Orthodontics and Dentofacial OrthopedicsDental Providers
Taxonomy Code1223X0400X
License Licensed in PA · 3338
Definition
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.
1115 W FRIENDLY AVE, Greensboro, NC 27401

Other Providers at the Same Location NPPES 3

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

Dentist (General Practice)
1115 W FRIENDLY AVE
GREENSBORO, NC 27401
Dentist (General Practice)
1115 W FRIENDLY AVE
GREENSBORO, NC 27401
Dentist (General Practice)
1115 W FRIENDLY AVE
GREENSBORO, NC 27401

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 Jerry Clark's NPI number?

The NPI number for Jerry Clark is 1619203551. It was assigned to this individual provider in the NPPES registry on October 28, 2009.

Where is Jerry Clark located?

Jerry Clark practices at 1115 W Friendly Ave, Greensboro, NC 27401. The listed phone number is (336) 273-2528.

What is Jerry Clark's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Orthodontics and Dentofacial Orthopedics, with taxonomy code 1223X0400X.

When was this NPI record last updated?

The NPPES record for Jerry Clark was last updated on October 28, 2009. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 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.