DR. CLARK KENNETH KVISTAD D.D.S.
NPI 1093948267
Dentist - Periodontics in Edmonds, WA

Q: What is Clark Kvistad's NPI number?

The NPI number for Clark Kvistad is 1093948267. It was assigned to this individual provider in the NPPES registry on September 3, 2009.

Q: What is Clark Kvistad's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Periodontics, with taxonomy code 1223P0300X.

Q: When was this NPI record last updated?

The NPPES record for Clark Kvistad was last updated on September 3, 2009. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since September 03, 2009

21807 76TH AVE W, EDMONDS, WA 98026(425) 775-2002 Get Directions Write a Review

NPPES record last updated: September 3, 2009. Verified against the NPPES registry weekly; last sync: August 16, 2026.

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About Dr. Clark Kenneth Kvistad D.d.s. NPPES

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

DR. CLARK KENNETH KVISTAD D.D.S. (NPI 1093948267) is an individual periodontics provider in Edmonds, Washington, licensed in Washington (3580) and active in the NPI registry since September 2009.

NPPES Registry Identity

NPI1093948267

Entity TypeIndividualMale

Primary Taxonomy1223P0300X

Provider Legal NameDR. CLARK KENNETH KVISTADCredential: D.D.S.

Location Address21807 76TH AVE WEdmonds, WA 98026-7938

Mailing Address21807 76th Ave WEdmonds, WA 98026-7938 · (425) 775-2002

Phone(425) 775-2002

Sole ProprietorNo

Enumeration DateSeptember 3, 2009

✔ NPI 1093948267 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · PeriodonticsDental Providers

Taxonomy Code1223P0300X

License✔ Licensed in WA · 3580

Definition

That specialty of dentistry which encompasses the prevention, diagnosis and treatment of diseases of the supporting and surrounding tissues of the teeth or their substitutes and the maintenance of the health, function and esthetics of these structures and tissues.

21807 76TH AVE W, Edmonds, WA 98026

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Other Providers at the Same Location NPPES

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

JUSTIN M PAGAN D.D.S., M.S.D.

Dentist (Orthodontics and Dentofacial Orthopedics)

21807 76TH AVE W
EDMONDS, WA 98026

Snohomish County (425) 775-3564

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 Clark Kvistad's NPI number?

The NPI number for Clark Kvistad is 1093948267. It was assigned to this individual provider in the NPPES registry on September 3, 2009.

Where is Clark Kvistad located?

Clark Kvistad practices at 21807 76th Ave W, Edmonds, WA 98026. The listed phone number is (425) 775-2002.

What is Clark Kvistad's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Periodontics, with taxonomy code 1223P0300X.

When was this NPI record last updated?

The NPPES record for Clark Kvistad was last updated on September 3, 2009. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.