DR. SHAWNA CLARK D.D.S.
NPI 1417398553
Dentist - General Practice in Memphis, TN

Q: What is Shawna Clark's NPI number?

The NPI number for Shawna Clark is 1417398553. It was assigned to this individual provider in the NPPES registry on July 16, 2013.

Q: What is Shawna 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 Shawna Clark was last updated on April 17, 2015. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 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 July 16, 2013PECOS Enrolled

5366 MENDENHALL MALL, MEMPHIS, TN 38115(901) 701-2730(901) 271-6195 Get Directions Write a Review

NPPES record last updated: April 17, 2015. Verified against the NPPES registry weekly; last sync: October 18, 2026.

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About Dr. Shawna Clark D.d.s. NPPES

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

DR. SHAWNA CLARK D.D.S. (NPI 1417398553) is an individual general practice provider in Memphis, Tennessee, licensed in Tennessee (9702) and active in the NPI registry since July 2013. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1417398553

Entity TypeIndividualFemale

Primary Taxonomy1223G0001X

Provider Legal NameDR. SHAWNA CLARKCredential: D.D.S.

Location Address5366 MENDENHALL MALLMemphis, TN 38115-4505

Mailing Address5366 Mendenhall MallMemphis, TN 38115-4505 · (901) 701-2730 · Fax (901) 271-6195

Phone(901) 701-2730

Fax(901) 271-6195

Sole ProprietorNo

Enumeration DateJuly 16, 2013

Last NPPES UpdateApril 17, 2015

✔ NPI 1417398553 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · General PracticeDental Providers

Taxonomy Code1223G0001X

License✔ Licensed in TN · 9702

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.

5366 MENDENHALL MALL, Memphis, TN 38115

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, BEST Life, Blue Cross and Blue Shield of Montana and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Shawna 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.

Medicare Billing Reassignment

Medicare enrollment records show Shawna Clark reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Christ Community Health Services, Inc

Same address

Federally Qualified Health Center (FQHC)

5366 MENDENHALL MALL
Memphis, TN 38115

Reassigned Medicare billing, Tennessee enrollment
101 clinicians in this Medicare group

NPI 1841513058 (901) 271-6100

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 38115 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

$81.53 typical visit price

range $52.64 – $160.89

Typical copayment $20.38 (range $13.16 – $40.22)

Most-billed visit code 99203

Established Patient

$66.01 typical visit price

range $16.72 – $131.41

Typical copayment $16.50 (range $4.18 – $32.85)

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 16

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

TESSA DENZIN PA

Physician Assistant