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KELLY CLARK DDS PC
NPI 1982839056
Dentist - General Practice in Decatur, IL

Active since May 19, 2009
3737 E ROUTE 36, DECATUR, IL 62521(217) 423-2400 Get Directions Write a Review

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

About Kelly Clark Dds Pc NPPES

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

KELLY CLARK DDS PC (NPI 1982839056), doing business as Decatur Dental Care, is a healthcare organization registered as a general practice in Decatur, Illinois and active in the NPI registry since May 2009. The organization lists Kelly Clark, Doctor Owner, as its authorized official.

NPPES Registry Identity

NPI1982839056
Entity TypeOrganization
Primary Taxonomy1223G0001X
Legal Business NameKELLY CLARK DDS PC
Location Address3737 E ROUTE 36Decatur, IL 62521
Mailing Address3737 E Route 36Decatur, IL 62521 · (217) 423-2400
Phone(217) 423-2400
Organization SubpartNo
Authorized OfficialKelly ClarkDoctor Owner · (217) 423-2400
Enumeration DateMay 19, 2009
Last NPPES UpdateJune 9, 2026
NPPES CertifiedJune 9, 2026
✔ NPI 1982839056 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · General PracticeDental Providers
Taxonomy Code1223G0001X
License✔ Licensed in IL · 060009717
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.
3737 E ROUTE 36, Decatur, IL 62521
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Other Names 1

Doing Business AsDecatur Dental Care

Other Identifiers 4

Other1073693883IL · Blue Cross
Other1700959020IL · Blue Cross
Other1801059100IL · Blue Cross
Other1942379458IL · Blue Cross

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 Kelly Clark Dds PC's NPI number?

The NPI number for Kelly Clark Dds PC is 1982839056. It was assigned to this organization in the NPPES registry on May 19, 2009. The provider is doing business as Decatur Dental Care.

Where is Kelly Clark Dds PC located?

Kelly Clark Dds PC is located at 3737 E Route 36, Decatur, IL 62521. The listed phone number is (217) 423-2400.

What is Kelly Clark Dds PC'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 Kelly Clark Dds PC was last updated on June 9, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 months 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.