National Provider Identifier Database

CARLY R CLARK, RDH, EP – NPI #1760827356
Advanced Practice Dental Therapist

An Advanced Practice Dental Therapist is: (1) A dental therapist who has completed additional training beyond basic dental therapy education and provides dental services in accordance with state advanced practice dental therapist laws or statutes; or (2) A dental hygienist with a graduate degree in advanced dental therapy prepared for independent and interdependent decision making and direct accountability for clinical judgment across the dental health care continuum. The individual has been authorized by the relevant state board or a tribal entity to provide services under the remote supervision of a dentist. The functions of the advanced practice dental therapist vary based on the needs of the dentist, the educational preparation of the advanced practice dental therapist and state dental practice acts and regulations.


Contact Information

CARLY R CLARK, RDH, EP
3324 N ARLINGTON PL
PORTLAND, OR97217-7204
Phone: 503-887-5923
Fax:
Website:
Specialty Taxonomy Code
* Advanced Practice Dental Therapist 125K00000X

* Indicates primary specialty

NPI Profile & details for CARLY R CLARK

NPI Number 1760827356
Credentials RDH, EP
Entity Individual
Enumeration date 05/08/2013
Last updated 05/08/2013 - About 13 years ago
Sole proprietor1 Yes
Identifiers
  • OR License #: H5380
Hospital affiliation n/a

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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