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DR. DAKOTA B CLARK DMD
NPI 1417449349
Dentist - General Practice in Jacksonville, AL

Active since June 06, 2018PECOS Enrolled
1450 1ST AVE SW, JACKSONVILLE, AL 36265(256) 435-2007(256) 435-4669 Get Directions Write a Review

NPPES record last updated: October 15, 2020. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Dr. Dakota B Clark Dmd NPPES

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

DR. DAKOTA B CLARK DMD (NPI 1417449349) is an individual general practice provider in Jacksonville, Alabama, licensed in Alabama (6493) and active in the NPI registry since June 2018. He is enrolled in Medicare PECOS and maintains 2 additional practice locations.

NPPES Registry Identity

NPI1417449349
Entity TypeIndividualMale
Primary Taxonomy1223G0001X
Provider Legal NameDR. DAKOTA B CLARKCredential: DMD
Location Address1450 1ST AVE SWJacksonville, AL 36265-3329
Mailing Address1450 1st Ave SwJacksonville, AL 36265-3329 · (256) 435-2007 · Fax (256) 435-4669
Phone(256) 435-2007
Fax(256) 435-4669
Sole ProprietorNo
Enumeration DateJune 6, 2018
Last NPPES UpdateOctober 15, 2020
NPPES CertifiedOctober 13, 2020
✔ NPI 1417449349 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · General PracticeDental Providers
Taxonomy Code1223G0001X
License✔ Licensed in AL · 6493
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.
1450 1ST AVE SW, Jacksonville, AL 36265
Open in Google Maps ↗

Secondary Practice Locations 2

Location 176 County Road 64Woodland, AL 36280-5209 · Phone (256) 449-2448
Location 21695 Golden Springs RdAnniston, AL 36207-7097 · Phone (256) 831-1333

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of Alabama, Delta Dental PPO.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)

Dr. Dakota B Clark Dmd 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 36265 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
$81.90 typical visit price
range $52.65 – $161.63
Typical copayment $20.47 (range $13.16 – $40.40)
Most-billed visit code 99203
Established Patient
$66.08 typical visit price
range $16.56 – $131.65
Typical copayment $16.52 (range $4.14 – $32.91)
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 3

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

DR. BRUCE EDWARD CUNNINGHAM DMD
Dentist (General Practice)
1450 1ST AVE SW
JACKSONVILLE, AL 36265
Calhoun County (256) 435-2007
DAKOTA B CLARK DMD LLC
Dentist (General Practice)
1450 1ST AVE SW
JACKSONVILLE, AL 36265
Calhoun County (256) 435-2007
BRUCE E. CUNNINGHAM, DMD PC
Dentist (General Practice)
1450 1ST AVE SW
JACKSONVILLE, AL 36265
Calhoun County (256) 435-2007

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 Dakota Clark's NPI number?

The NPI number for Dakota Clark is 1417449349. It was assigned to this individual provider in the NPPES registry on June 6, 2018.

Where is Dakota Clark located?

Dakota Clark practices at 1450 1st Ave SW, Jacksonville, AL 36265. The listed phone number is (256) 435-2007.

What is Dakota Clark's specialty?

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

Is Dakota Clark enrolled in Medicare?

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

What insurance does Dakota Clark accept?

Health plans from Blue Cross and Blue Shield of Alabama and Delta Dental PPO list Dakota 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 Dakota Clark was last updated on October 15, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.