Jeffry Stephen Clark in Reston - Dentist
Jeffry Stephen Clark - NPI 1790821429
Jeffry Stephen Clark is a Dentist in Reston, Virginia. Jeffry Stephen Clark practices all healthcare services and medical treatments related to Dentist. The NPI Number for Jeffry Stephen Clark is 1790821429. The last update date is 2007-07-08.
Jeffry Stephen Clark's current location address is 1950 Roland Clarke Pl, Reston, Virginia. You can contact this provider via phone number 7033912600 and fax number 7033912097. The mailing address for Jeffry Stephen Clark is 1950 Roland Clarke Pl, Reston, Virginia. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Jeffry Stephen Clark |
|---|---|
| Address | 1950 Roland Clarke Pl, Reston, Virginia |
| Phone Number | 7033912600 |
| Fax Number | 7033912097 |
| Sole Proprietor | N |
| Credentials | D.D.S. |
NPI Number Detail
| NPI Number | 1790821429 |
|---|---|
| Provider Enumeration Date | 2007-01-29 |
| Last Updated Date | 2007-07-08 |
Provider Mailing Address Detail
| Address | 1950 Roland Clarke Pl |
|---|---|
| City | Reston |
| State | Virginia (VA) |
| Post Code | 201911414 |
| Phone Number | 7033912600 |
| Fax Number | 7033912097 |
Provider's Primary Taxonomy Detail
| Speciality | Dentist |
|---|---|
| Taxonomy | 122300000X |
| Licence No | 401008224 |
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Definition: A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: denti |
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What is the unique 10-digit identifier code assigned to Jeffry Stephen Clark by the Centers for Medicare & Medicaid Services?
The Jeffry Stephen Clark has been issued the NPI (National Provider Identifier) 1790821429 by the CMS (Centers for Medicare & Medicaid Services), which serves as a unique identification number for healthcare providers.
Could you kindly provide the complete physical address where Jeffry Stephen Clark's facilities are geographically located?
The facilities of Jeffry Stephen Clark are physically situated at the following location: 1950 Roland Clarke Pl, Reston, VA, 201911414.
What is the Jeffry Stephen Clark's specialty and taxonomy code?
The Jeffry Stephen Clark's specialty is Dentist, and the corresponding taxonomy code is 122300000X.
On what date did the Centers for Medicare & Medicaid Services assign the 1790821429 to Jeffry Stephen Clark?
The Centers for Medicare & Medicaid Services assigned the 1790821429 to Jeffry Stephen Clark on 2007-01-29.
As of what date were the details pertaining to Jeffry Stephen Clark last refreshed?
The information related to the Jeffry Stephen Clark, including its address, specialty, and other relevant details, was last updated on 2007-07-08.