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MR. DALE WOODALL CLARK DMD
NPI 1144339177
Dentist in Russellville, KY

Active since August 30, 2006Opted out of Medicare · through Feb 1, 2028
204 EAST FOURTH ST, RUSSELLVILLE, KY 42276(270) 726-7511(270) 726-6831 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Mr. Dale Woodall Clark Dmd NPPES

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

MR. DALE WOODALL CLARK DMD (NPI 1144339177) is an individual dentist in Russellville, Kentucky, licensed in Kentucky (5933) and active in the NPI registry since August 2006. He has opted out of Medicare through February 1, 2028 and remains eligible to order and refer.

NPPES Registry Identity

NPI1144339177
Entity TypeIndividualMale
Primary Taxonomy122300000X
Provider Legal NameMR. DALE WOODALL CLARKCredential: DMD
Location Address204 EAST FOURTH STRussellville, KY 42276
Mailing Address204 East Fourth StRussellville, KY 42276 · (270) 726-7511 · Fax (270) 726-6831
Phone(270) 726-7511
Fax(270) 726-6831
Sole ProprietorNo
Enumeration DateAugust 30, 2006
Last NPPES UpdateJuly 8, 2007
✔ NPI 1144339177 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentistDental Providers
Taxonomy Code122300000X
License✔ Licensed in KY · 5933
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.
204 EAST FOURTH ST, Russellville, KY 42276
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Other Identifiers 1

Medicaid60059334KY

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter from Home State Health, Ambetter Health and more.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

Mr. Dale Woodall 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 1, 2016 through February 1, 2028.

Opt-Out Effective DateFebruary 1, 2016
Opt-Out In Effect ThroughFebruary 1, 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 42276 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
$82.24 typical visit price
range $52.76 – $162.27
Typical copayment $20.56 (range $13.19 – $40.56)
Most-billed visit code 99203
Established Patient
$66.24 typical visit price
range $16.53 – $131.99
Typical copayment $16.56 (range $4.13 – $32.99)
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.

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 Dale Clark's NPI number?

The NPI number for Dale Clark is 1144339177. It was assigned to this individual provider in the NPPES registry on August 30, 2006.

Where is Dale Clark located?

Dale Clark practices at 204 East Fourth St, Russellville, KY 42276. The listed phone number is (270) 726-7511.

What is Dale Clark's specialty?

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

Is Dale Clark enrolled in Medicare?

No. Dale Clark has opted out of Medicare through February 1, 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 Dale Clark accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Home State Health, Ambetter of Tennessee and Anthem Blue Cross and Blue Shield and 10 other insurers list Dale 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 Dale Clark was last updated on July 8, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 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.