Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days.
Organization
JEV A. CLARK, DMD, MD, LLC
Active
Organization
JEV A. CLARK, DMD, MD, LLC
Active
Other names
Clark Implant & Oral Surgery
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JEV A CLARK DMD, MD (DOCTOR)
(503) 371-6000
Entity
Organization
Contact information
Practice address
120 RAMSGATE SQ S STE 110, SALEM, OR 97302-5870
(503) 371-6000
Mailing address
120 RAMSGATE SQ S STE 110, SALEM, OR 97302-5870
(503) 371-6000
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
D10561
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
D10561
DENTAL LICENSE
OR
01
—
MD176989
MEDICAL LICENSE
OR
Enumeration date
04/19/2018
Last updated
04/19/2018
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up