AMITY GENTLE DENTAL (DR. CHESTER V. CLARK, JR. D.D.S., M.P.H., P.C.) NPI 1962574327

Dentist (General Practice) in Amity, AR

NPI 1962574327 Organization Dentist General Practice

About AMITY GENTLE DENTAL (DR. CHESTER V. CLARK, JR. D.D.S., M.P.H., P.C.)

Amity Gentle Dental (dr. Chester V. Clark, Jr. D.d.s., M.p.h., P.c.) is a provider established in Amity, Arkansas specializing in dentist (general practice) . The NPI number of Amity Gentle Dental (dr. Chester V. Clark, Jr. D.d.s., M.p.h., P.c.) is 1962574327 and was assigned on November 2006. The practitioner's primary taxonomy code is 1223G0001X with license number 2228 (AR). The provider is registered as an organization and their NPI record was last updated 10 years ago. Amity Gentle Dental (dr. Chester V. Clark, Jr. D.d.s., M.p.h., P.c.) operates as a single speciality business group with one or more individual providers who practice the same area of specialization. The provider's is doing business as Amity Gentle Dental. The authorized official of this NPI record is Dr. Chester V Clark Jr. Dds, Mph (President)

A dentist like Amity Gentle Dental is a skilled in and licensed provider that diagnoses and treats problems with patients teeth, gums, and related parts of the mouth. Dentists educate patients on how to take care of the teeth and gums and provide information on diet choices that affect oral health. Dentists must be licensed in the state in which they work.

NPI

1962574327

Provider NameAMITY GENTLE DENTAL (DR. CHESTER V. CLARK, JR. D.D.S., M.P.H., P.C.)
Provider Location Address439 E THOMPSON ST AMITY, AR 71921
Provider Mailing AddressPO BOX 154 AMITY, AR 71921
NPI Entity TypeOrganization
Is Sole Proprietor?N/A
Is Organization Subpart?No
Other Organization NameAMITY GENTLE DENTAL
Other Name TypeDoing Business As (3)
Enumeration Date11-14-2006
Last Update Date01-25-2012


Primary Taxonomy

Taxonomy Code1223G0001X
ClassificationDentist
TypeDental Providers
SpecializationGeneral Practice
License No.2228
License StateAR
Taxonomy DescriptionA general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.

Business Address

AMITY GENTLE DENTAL
439 E THOMPSON ST
AMITY, AR
ZIP 71921
Phone: (870) 342-5265
Fax: (870) 342-6292

Get Directions


Mailing Address

AMITY GENTLE DENTAL
PO BOX 154
AMITY, AR
ZIP 71921
Phone: (870) 342-5265
Fax: (870) 342-6292



Authorized Official

Authorized Official NameDR. CHESTER V CLARK JR. DDS, MPH
Authorized Official TitlePRESIDENT
Authorized Official Phone(870) 342-5265

Group Taxonomy


193400000X SINGLE SPECIALTY GROUP - This provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.

Additional Identifiers


Additional identifier(s) currently or formerly used as an identifier for the provider. The codes may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State
58932OTHER (01)AR
101460608MEDICAID (05)AR
809875OTHER (01)AR

Other Providers at the same location


The following provider is registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1750653127DR. CHESTER VAN CLARK JR. D.D.S., M.P.H.
Individual
Dentist (General Practice)439 E THOMPSON ST
AMITY, AR 71921
(870) 342-5265

NPI Footnotes

What is the National Provider Indentifier (NPI)?
The NPI is 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.

Provider Location Address
The location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.

Provider Mailing Address
The mailing address of the provider being identified. This address may contain the same information as the provider location address.

Entity Type Code
The code describing the type of health care provider that is being assigned an NPI.
The entity type codes are:
1 = Person: individual human being who furnishes health care;
2 = Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)

What is a Subpart?
Subparts are the components and separate physical locations of organization health care providers. Subpart examples include:
Hospital components include outpatient departments, surgical centers, psychiatric units, and laboratories. These components are often separately licensed or certified by States and may exist at physical locations other than that of the hospital of which they are a component.

Provider Other Organization Name
The other organization name is the alternative last name by which the provider is or has been known (if an individual) or other name by which the organization provider is or has been known. The code identifying the type of other name. The provider other organization name codes are:
1 = former name;
2 = professional name;
3 = doing business as (d/b/ a) name;
4 = former legal business name; :
5 = other.

Provider Enumeration Date
The date the provider was assigned a unique identifier (assigned an NPI).

Last Update Date
The date that a NPI record was last updated or changed.

Primary Taxonomy Code
The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Authorized Official Name
The name of the person authorized to submit the NPI application or to officially change data for a health care provider.