Kelly Clark DDS PC
NPI 1982839056ActiveOrganization· Dentist, General Practice· Decatur, IL
Dentist, General Practice in Decatur, Illinois, registered in NPPES in May 2009. The authorized official on file is Kelly Clark, DDS, Doctor Owner.
Overview
| NPI | 1982839056 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | May 19, 2009 |
| Last updated in NPPES | Jun 9, 2026 |
| Certified by provider | Jun 9, 2026 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Dentist, General Practice Primary | 1223G0001X | 060009717 | IL |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Not in the public enrollment file of Oct 1, 2026 |
|---|
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