DR. SAUNDRA C CLARK DMD
NPI 1053592592
Dentist in Philadelphia, PA

Active since November 26, 2007Opted out of Medicare · through Feb 8, 2028
4401 CONSHOHOCKEN AVE, DENTAL SUITE, PHILADELPHIA, PA 19131(215) 877-9111 Get Directions Write a Review

NPPES record last updated: November 26, 2007. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Dr. Saundra C Clark Dmd NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. SAUNDRA C CLARK DMD (NPI 1053592592) is an individual dentist in Philadelphia, Pennsylvania, licensed in Pennsylvania (DS031094L) and active in the NPI registry since November 2007. She has opted out of Medicare through February 8, 2028 and remains eligible to order and refer.

NPPES Registry Identity

NPI1053592592
Entity TypeIndividualFemale
Primary Taxonomy122300000X
Provider Legal NameDR. SAUNDRA C CLARKCredential: DMD
Location Address4401 CONSHOHOCKEN AVE, DENTAL SUITEPhiladelphia, PA 19131-1553
Mailing Address4401 Conshohocken Ave, Dental SuitePhiladelphia, PA 19131-1553 · (215) 877-9111
Sole ProprietorYes
Enumeration DateNovember 26, 2007
NPI 1053592592 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyDentistDental Providers
Taxonomy Code122300000X
License Licensed in PA · DS031094L
Definition

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.

4401 CONSHOHOCKEN AVE, Philadelphia, PA 19131

Accepted Insurance

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Opted out of Medicare

Dr. Saundra C Clark Dmd has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from February 8, 2016 through February 8, 2028.

Opt-Out Effective DateFebruary 8, 2016
Opt-Out In Effect ThroughFebruary 8, 2028Opt-out affidavits renew automatically every two years unless cancelled
Eligible to Order & Refer Part B Labs & Imaging Durable Medical Equipment Home Health Agency Power Mobility DevicesAn opted-out provider can still order and refer for Medicare patients in the categories marked above, even though their own services are not covered.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 19131 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$92.69 typical visit price
range $59.88 – $180.99
Typical copayment $23.17 (range $14.97 – $45.24)
Most-billed visit code 99203
Established Patient
$74.47 typical visit price
range $19.30 – $147.29
Typical copayment $18.61 (range $4.82 – $36.82)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Dentist (Orthodontics and Dentofacial Orthopedics)
4401 CONSHOHOCKEN AVE, DENTAL SUITE
PHILADELPHIA, PA 19131
Dentist (General Practice)
4401 CONSHOHOCKEN AVE, SUITE 1
PHILADELPHIA, PA 19131
Counselor
4401 CONSHOHOCKEN AVE, APT C10
PHILADELPHIA, PA 19131

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Saundra Clark's NPI number?

The NPI number for Saundra Clark is 1053592592. It was assigned to this individual provider in the NPPES registry on November 26, 2007.

Where is Saundra Clark located?

Saundra Clark practices at 4401 Conshohocken Ave Dental Suite, Philadelphia, PA 19131. The listed phone number is (215) 877-9111.

What is Saundra Clark's specialty?

The primary specialty registered for this NPI is Dentist with taxonomy code 122300000X.

Is Saundra Clark enrolled in Medicare?

No. Saundra Clark has opted out of Medicare through February 8, 2028. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out. The provider remains eligible to order and refer services for Medicare patients.

What insurance does Saundra Clark accept?

Health plans from BEST Life, Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma, Blue Cross and Blue Shield of Texas and Florida Combined Life and 5 other insurers list Saundra Clark as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Saundra Clark was last updated on November 26, 2007. NPI Profile syncs with the weekly NPPES data releases published by CMS.