Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Clark D Andelin, DMD, MD

Individual provider Oral & Maxillofacial Surgery (D.M.D.) · NPI 1043538705

Clark D Andelin, DMD, MD is an Oral Surgery in Philadelphia, Pennsylvania. Qualified in 2014, 12 years ago. Practices with Northeast Washington County Community Health, Inc, an 18-clinician group and accepts Medicare assignment. Licensed in Pennsylvania and Vermont.

Years since qualifying
12
Licensed in
PA, VT
In the registry since
2010
Specialties on file
3
What do these letters mean?
DMD — Doctor of Dental Medicine
A dentist. Identical training and licensing to a DDS.
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

3400 Spruce St
Philadelphia, PA 19104-4206
Phone: (215) 662-6176
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Oral and Maxillofacial Surgery (Dentist) (primary) Taxonomy 1223S0112X · Licence DS038552 (PA)
Oral & Maxillofacial Surgery (D.M.D.) Taxonomy 204E00000X · Licence MT207339 (PA)
Oral and Maxillofacial Surgery (Dentist) Taxonomy 1223S0112X · Licence 016.0125577 (VT)

Record details

NPI number1043538705
Entity typeIndividual (Type 1)
GenderMale
Credentials DMD , MD
Sole proprietorNo
NPI enumeratedMay 5, 2010
Last updated in NPPESJanuary 20, 2017

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyORAL SURGERY
Medical schoolOTHER
Graduated 2014 (12 years in practice)
Group practice Northeast Washington County Community Health, Inc. — 18 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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