MEDICARE: DR. JAMES A CLARK DMD,MS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223S0112X	Oral and Maxillofacial Surgery (Dentist)	389	AK

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	831476	OTHER	AK	TRI-CARE ID

General Provider Information

NPI Number	:	1376557736
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JAMES A CLARK DMD,MS

Provider Business Mailing Address
First Line	:	3650 LAKE OTIS PKWY
Second Line	:	SUITE 201
City	:	ANCHORAGE
State	:	AK
Zip	:	99508-5207
Country	:	US
Telephone Number	:	907-561-1430
Fax Number	:	907-561-2697

Provider Business Practice Location Address
First Line	:	3650 LAKE OTIS PKWY
Second Line	:	SUITE 201
City	:	ANCHORAGE
State	:	AK
Zip	:	99508-5207
Country	:	US
Telephone Number	:	907-561-1430
Fax Number	:	907-561-2697

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/28/2006
Last Update Date	:	07/09/2007

Similar Medicare Providers

1801898473 — DR. JAYESH MAKIM MD
Practice Location Address:

3650 LAKE OTIS PKWY , SUITE 205
ANCHORAGE, AK
99508-5207

Practice Phone: 907-561-1565
Practice Fax: 907-561-1541

1720080377 — NORTHERN NEUROLOGY CONSULTANTS, LLC.
Practice Location Address:

3650 LAKE OTIS PKWY , SUITE 205
ANCHORAGE, AK
99508-5207

Practice Phone: 907-563-1565
Practice Fax: 907-561-1541

1821159674 — DR. ROBERT K THORNQUIST M.D.
Practice Location Address:

3650 LAKE OTIS PKWY , SUITE 104
ANCHORAGE, AK
99508-5207

Practice Phone: 907-561-3836
Practice Fax: 907-561-3858

1205981768 — JANICE K ROYCE L.AC.
Practice Location Address:

3600 LAKE OTIS PKWY , SUITE 200
ANCHORAGE, AK
99508-5207

Practice Phone: 907-830-0273
Practice Fax:

1558589556 — DR. KENNETH D OLDHAM D.M.D.
Practice Location Address:

3650 LAKE OTIS PKWY , SUITE 102
ANCHORAGE, AK
99508-5207

Practice Phone: 907-563-5820
Practice Fax: 907-562-7029

1356553655 — PAULA KORN ANP
Practice Location Address:

3650 LAKE OTIS PKWY , SUITE 140
ANCHORAGE, AK
99508-5207

Practice Phone: 907-277-2597
Practice Fax: 907-277-2598

Directions to “ DR. JAMES A CLARK DMD,MS” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.