ELIZABETH JANE CLARK D.D.S.
NPI 1407038128
Dentist - General Practice in Old Lyme, CT

Q: What is Elizabeth Clark's NPI number?

The NPI number for Elizabeth Clark is 1407038128. It was assigned to this individual provider in the NPPES registry on December 4, 2007.

Q: What is Elizabeth Clark's specialty?

The primary specialty registered for this NPI is Dentist, specializing in General Practice, with taxonomy code 1223G0001X.

Q: When was this NPI record last updated?

The NPPES record for Elizabeth Clark was last updated on March 9, 2010. 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 December 04, 2007PECOS Enrolled

19 HALLS RD STE 218, OLD LYME, CT 06371(860) 434-7378 Get Directions Write a Review

NPPES record last updated: March 9, 2010. Verified against the NPPES registry weekly; last sync: August 23, 2026.

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About Elizabeth Jane Clark D.d.s. NPPES

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

ELIZABETH JANE CLARK D.D.S. (NPI 1407038128) is an individual general practice provider in Old Lyme, Connecticut, licensed in Connecticut (009894) and active in the NPI registry since December 2007. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1407038128

Entity TypeIndividualFemale

Primary Taxonomy1223G0001X

Provider Legal NameELIZABETH JANE CLARKCredential: D.D.S.

Location Address19 HALLS RD STE 218Old Lyme, CT 06371-1457

Mailing Address19 Halls Rd Ste 218, Po Box 551Old Lyme, CT 06371-1457 · (860) 434-7378

Phone(860) 434-7378

Sole ProprietorNo

Enumeration DateDecember 4, 2007

Last NPPES UpdateMarch 9, 2010

✔ NPI 1407038128 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · General PracticeDental Providers

Taxonomy Code1223G0001X

License✔ Licensed in CT · 009894

Definition

A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.

19 HALLS RD STE 218, Old Lyme, CT 06371

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma, Blue Cross and Blue Shield of Texas.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Elizabeth Jane Clark D.d.s. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 06371 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

$93.86 typical visit price

range $60.82 – $183.10

Typical copayment $23.46 (range $15.20 – $45.77)

Most-billed visit code 99203

Established Patient

$75.55 typical visit price

range $19.76 – $149.26

Typical copayment $18.88 (range $4.94 – $37.31)

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 Elizabeth Clark's NPI number?

The NPI number for Elizabeth Clark is 1407038128. It was assigned to this individual provider in the NPPES registry on December 4, 2007.

Where is Elizabeth Clark located?

Elizabeth Clark practices at 19 Halls Rd Ste 218, Old Lyme, CT 06371. The listed phone number is (860) 434-7378.

What is Elizabeth Clark's specialty?

The primary specialty registered for this NPI is Dentist, specializing in General Practice, with taxonomy code 1223G0001X.

Is Elizabeth Clark enrolled in Medicare?

Yes. Elizabeth Clark is registered in the Medicare PECOS enrollment system.

What insurance does Elizabeth Clark accept?

Health plans from Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma and Blue Cross and Blue Shield of Texas list Elizabeth 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 Elizabeth Clark was last updated on March 9, 2010. 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.