SOUTEL DENTAL CENTER II
NPI 1295023752
Dentist in Jacksonville, FL

Q: What is Bennie Clark Jr Dmd PA's NPI number?

The NPI number for Bennie Clark Jr Dmd PA is 1295023752. It was assigned to this organization in the NPPES registry on July 19, 2011. The provider is doing business as Soutel Dental Center II.

Q: What is Bennie Clark Jr Dmd PA's specialty?

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

Active since July 19, 2011

5475 SOUTEL DR, JACKSONVILLE, FL 32219(904) 764-4576(904) 722-9900 Get Directions Write a Review

NPPES record last updated: November 1, 2019. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Soutel Dental Center Ii NPPES

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

SOUTEL DENTAL CENTER II (NPI 1295023752) is a healthcare organization registered as a dentist in Jacksonville, Florida and active in the NPI registry since July 2011. The organization lists Lorraine Polite Clark, Vice President, as its authorized official.

NPPES Registry Identity

NPI1295023752

Entity TypeOrganization

Primary Taxonomy122300000X

Legal Business NameBENNIE CLARK JR DMD PA

Location Address5475 SOUTEL DRJacksonville, FL 32219-3464

Mailing Address5475 Soutel DrJacksonville, FL 32219-3464 · (904) 764-4576 · Fax (904) 722-2200

Phone(904) 764-4576

Fax(904) 722-9900

Organization SubpartNo

Authorized OfficialLorraine Polite ClarkVice President · (904) 722-2200

Enumeration DateJuly 19, 2011

Last NPPES UpdateNovember 1, 2019

✔ NPI 1295023752 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyDentistDental Providers

Taxonomy Code122300000X

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.

Also ListedDental HygienistTaxonomy 124Q00000X

5475 SOUTEL DR, Jacksonville, FL 32219

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Other Names 1

Doing Business AsSoutel Dental Center Ii

Other Identifiers 1

Medicaid071395300FL

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X MULTIPLE SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter Health, Ambetter of Alabama.Insurance ›

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 Bennie Clark Jr Dmd PA's NPI number?

The NPI number for Bennie Clark Jr Dmd PA is 1295023752. It was assigned to this organization in the NPPES registry on July 19, 2011. The provider is doing business as Soutel Dental Center II.

Where is Bennie Clark Jr Dmd PA located?

Bennie Clark Jr Dmd PA is located at 5475 Soutel Dr, Jacksonville, FL 32219. The listed phone number is (904) 764-4576.

What is Bennie Clark Jr Dmd PA's specialty?

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

What insurance does Bennie Clark Jr Dmd PA accept?

Health plans from Ambetter Health and Ambetter of Alabama list Bennie Clark Jr Dmd PA 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 Bennie Clark Jr Dmd PA was last updated on November 1, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.