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PARK AVENUE DENTAL
NPI 1689811853
Dentist - General Practice in Chippewa Falls, WI

Active since January 09, 2009
777 PARK AVENUE, CHIPPEWA FALLS, WI 54729(715) 723-0367 Get Directions Write a Review

NPPES record last updated: January 9, 2009. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Park Avenue Dental NPPES

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

PARK AVENUE DENTAL (NPI 1689811853) is a healthcare organization registered as a general practice in Chippewa Falls, Wisconsin and active in the NPI registry since January 2009. The organization lists Jeffrey Michael Clark, Dentist, as its authorized official.

NPPES Registry Identity

NPI1689811853
Entity TypeOrganization
Primary Taxonomy1223G0001X
Legal Business NameCLARK FAMILY DENTAL INC
Location Address777 PARK AVENUEChippewa Falls, WI 54729
Mailing Address777 Park AvenueChippewa Falls, WI 54729 · (715) 723-0367
Phone(715) 723-0367
Organization SubpartNo
Authorized OfficialJeffrey Michael ClarkDentist · (715) 723-0367
Enumeration DateJanuary 9, 2009
✔ NPI 1689811853 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · General PracticeDental Providers
Taxonomy Code1223G0001X
License✔ Licensed in WI · 6137015
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.
777 PARK AVENUE, Chippewa Falls, WI 54729
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Other Names 1

Doing Business AsPark Avenue Dental

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 SINGLE SPECIALTY GROUP

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 Clark Family Dental Inc's NPI number?

The NPI number for Clark Family Dental Inc is 1689811853. It was assigned to this organization in the NPPES registry on January 9, 2009. The provider is doing business as Park Avenue Dental.

Where is Clark Family Dental Inc located?

Clark Family Dental Inc is located at 777 Park Avenue, Chippewa Falls, WI 54729. The listed phone number is (715) 723-0367.

What is Clark Family Dental Inc's specialty?

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

When was this NPI record last updated?

The NPPES record for Clark Family Dental Inc was last updated on January 9, 2009. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 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.