MR. DALE WOODALL CLARK (NPI# 1144339177) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1144339177 |
| Entity Type | Individual |
| Full Name | MR. DALE WOODALL CLARK |
| Credential | DMD |
| Practice Address |
204 East Fourth St Russellville KY 42276 |
| Practice Telephone | 2707267511 |
| Practice Fax Number | 2707266831 |
| Mailing Telephone | 2707267511 |
| Mailing Fax Number | 2707266831 |
| Enumeration Date | 2006-08-30 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 122300000X | Dentist | 5933 | KY | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| KY | 60059334 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386787398 | Dale Eugene Clark | Chiropractor | 109 Rainier Ave So Ste C, Eatonville, WA 98328-0546 | 2007-02-15 |
| 1720153026 | Dale Thomas Clark | Chiropractor | 8907 Warner Ave Ste 160, Huntington Beach, CA 92647-5099 | 2006-11-21 |
| 1720400153 | Dale Clark | Massage Therapist | 3411 S Camino Seco Unit 231, Tucson, AZ 85730-2815 | 2014-01-21 |
| 1689824088 | Dale D Clark | Counselor | 325 E Pioneer Ave, Puyallup, WA 98372-3265 | 2008-09-23 |
| Street Address |
204 EAST FOURTH ST |
| City | RUSSELLVILLE |
| State | KY |
| Zip Code | 42276 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497302723 | Community Health Centers of Western Kentucky Inc | Family Medicine | 1497 Nashville Road, Russellville, KY 42276 | 2019-08-21 |
| 1104471911 | Lashawnda Lee | Nurse Practitioner | 60 Shelton Lane, Russellville, KY 42276 | 2019-08-08 |
| 1003940867 | Russellville Ind. Schools | Local Education Agency (LEA) | 355 S Seminary St, Russellville, KY 42276 | 2007-03-15 |
| 1083756217 | Robert Ellis Allison | Dentist | 248 East 5th Street, Russellville, KY 42276 | 2007-02-13 |
| 1578602033 | Acsr, Inc. | Clinic/Center | 3239 Lewisburg Rd, Russellville, KY 42276 | 2007-02-05 |
| 1568535250 | David Guion | Pharmacist | 153 Park Square Nw, Russellville, KY 42276 | 2006-11-17 |
| 1033120662 | Darla Sherrod Barrow | Optometrist | 709 East 4th St, Russellville, KY 42276 | 2006-08-10 |
| 1265405005 | Varsha Humble | Pediatrics | 1497 Nashville St, Russellville, KY 42276 | 2006-02-10 |
| 1235139247 | Darla Sherrod Barrow | Optometrist | 709 East 4th Street, Russellville, KY 42276 | 2005-08-01 |
| 1003327412 | Southern Kentucky Primary Care, P.s.c. | Family Medicine | 101 W 2nd St, Russellville, KY 42276 | 2017-10-12 |
| Find all providers in zip 42276 | ||||
| Taxonomy Code | 122300000X |
| Grouping | Dental Providers |
| Classification | Dentist |
| A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124670369 | Richard L Morgan Dds Pa | Dentist | 1700 West C Place, Russellville, AR 72801 | 2019-07-09 |
| 1447515770 | Michael Gregory Kitchens | Dentist | 104 N Utah Ave, Russellville, AR 72801-2740 | 2012-07-12 |
| 1083756217 | Robert Ellis Allison | Dentist | 248 East 5th Street, Russellville, KY 42276 | 2007-02-13 |
| 1518077601 | Robert A Young Jr. | Dentist | 104 N Utah, Russellville, AR 72801 | 2006-08-30 |
| 1366937906 | Jennifer Lynn Young | Dentist | 1700 W C Pl, Russellville, AR 72801-2773 | 2018-06-26 |
| 1689801243 | Brandi Hodge | Dentist | 2112 W Main St, Russellville, AR 72801-2758 | 2009-06-22 |
| 1073714770 | James Dustin Bonds | Dentist | 1919 W Main St, Russellville, AR 72801-2725 | 2007-05-30 |
| 1386774669 | Steven D. Hammack D.m.d. | Dentist | 531 Saint Clair St Se, Russellville, AL 35653-2719 | 2007-03-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548869878 | Miram Shaheen | Dentist | 600 Marshall St Unit 128, Louisville, KY 40202-3618 | 2020-10-19 |
| 1396351243 | Haaken Reed Magnuson | Dentist | 4600 Taylorsville Rd, Louisville, KY 40220-3530 | 2020-09-16 |
| 1043823586 | Rachad Kudsi | Dentist | 800 Rose St Lexington Ky, Lexington, KY 40536-0001 | 2020-08-25 |
| 1730799933 | Fernanda Yanez Regonesi | Dentist | 740 S Limestone Second Floor Wing C Room E214, Lexington, KY 40536-0001 | 2020-08-03 |
| 1629687181 | Joanna Higdon | Dentist | 4122 Shelbyville Rd Ste 103, Louisville, KY 40207-3206 | 2020-07-30 |
| 1184233702 | Amelia Beth Coleman | Dentist | 16005 Us-23 South, Catlettsburg, KY 41129 | 2020-07-29 |
| 1386253847 | Hannah Pope | Dentist | 6801 Dixie Hwy Ste 128, Louisville, KY 40258-3940 | 2020-07-29 |
| 1144838764 | My Smile Dental Services, Pllc | Dentist | 5014b Preston Hwy, Louisville, KY 40213-2217 | 2020-07-20 |
| 1205462967 | Florence Smiles Dentistry, Pllc | Dentist | 9031 Hwy 42 West, Ste A, Union, KY 41091 | 2020-03-13 |
| 1164068722 | Kentucky On-site Dental Services LLC | Dentist | 307 Longview Park Pl, Louisville, KY 40245-6217 | 2019-11-19 |
| Find all providers with the same taxonomy | ||||
| City | RUSSELLVILLE |
| Zip Code | 42276 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.