DR. RICHARD K CLARDY, D.M.D. - NPI NUMBER 1578543765

Summary

Provider Name: DR. RICHARD K CLARDY, D.M.D.

NPI Number: 1578543765

Clasification: Dentist (1223G0001X)

Specialization: General Practice

Address:
204 FAIRVIEW PARK DR
DUBLIN, GA
ZIP 31021

Phone Number: (478) 272-6777



Detailed Information

DR. Richard K Clardy, D.M.D. is a general practice dentist in Dublin, GA. The provider is a 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. The assigned NPI number for this provider is 1578543765 and is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business address is:

204 FAIRVIEW PARK DR
DUBLIN, GA
ZIP 31021-547
Phone: (478) 272-6777
Fax: (478) 272-6716

The enumeration date for this NPI number is 1/23/2006 and was last updated on 7/9/2007.

Map - Location of Practice

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Taxonomy Codes

The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1 1223G0001X Dentist General Practice DN011080 GA Yes

NPI Record

No. Field Name Field Value
1 NPI 1578543765
2 Entity Type Code 1
3 Provider Last Name Legal Name CLARDY
4 Provider First Name RICHARD
5 Provider Middle Name K
6 Provider Name Prefix Text DR.
7 Provider Credential Text D.M.D.
8 Provider First Line Business Practice Location Address 204 FAIRVIEW PARK DR
9 Provider Business Practice Location Address City Name DUBLIN
10 Provider Business Practice Location Address State Name GA
11 Provider Business Practice Location Address Postal Code 310212547
12 Provider Business Practice Location Address Country Code If outside U S US
13 Provider Business Practice Location Address Telephone Number 4782726777
14 Provider Business Practice Location Address Fax Number 4782726716
15 Provider Enumeration Date 1/23/2006
16 Last Update Date 7/9/2007
17 Provider Gender Code M
18 Healthcare Provider Taxonomy Code 1 1223G0001X
19 Provider License Number 1 DN011080
20 Provider License Number State Code 1 GA
21 Healthcare Provider Primary Taxonomy Switch 1 Y
22 Is Sole Proprietor X

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This page was last updated on: 3/11/2014
All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.