DR. JERRY CARL CLARKE DDS NPI 1356567010

NPI Information

NPI: 1356567010
Provider Name: DR. JERRY CARL CLARKE, DDS
Classification: Dentist - 1223P0300X
Entity Type: Individual

Specialization: Periodontics

Address:
2490 PRUDEN BLVD
SUFFOLK, VA
ZIP 23434
Phone: (757) 539-9398
Get Directions

DR. Jerry Carl Clarke, DDS is a periodontics dentist in Suffolk, VA. The provider is that specialty of dentistry which encompasses the prevention, diagnosis and treatment of diseases of the supporting and surrounding tissues of the teeth or their substitutes and the maintenance of the health, function and esthetics of these structures and tissues. DR. Jerry Carl Clarke, DDS NPI is 1356567010. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

2490 PRUDEN BLVD
SUFFOLK, VA
ZIP 23434-206
Phone: (757) 539-9398
Fax: (757) 539-9492

The enumeration date for this NPI number is 4/18/2007 and was last updated on 7/8/2007.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. 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	1223P0300X	Dentist	Periodontics	3823	VIRGINIA	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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.

« Previous NPI

Next NPI »