Provider Demographics
NPI:1114930724
Name:FILIPPI, CLARKE V (DDS)
Entity Type:Individual
Prefix:
First Name:CLARKE
Middle Name:V
Last Name:FILIPPI
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:809 SYLVAN AVE
Mailing Address - Street 2:STE. 300
Mailing Address - City:MODESTO
Mailing Address - State:CA
Mailing Address - Zip Code:95350-1500
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:809 SYLVAN AVE
Practice Address - Street 2:STE. 300
Practice Address - City:MODESTO
Practice Address - State:CA
Practice Address - Zip Code:95350-1500
Practice Address - Country:US
Practice Address - Phone:209-572-6008
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA446771223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics