KYLE ALLEN CLARK (NPI# 1639521206) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1639521206 |
| Entity Type | Individual |
| Full Name | KYLE ALLEN CLARK |
| Credential | D.M.D. |
| Practice Address |
113 Cross Creek Blvd Salem IL 62881-1921 |
| Practice Telephone | 6185484480 |
| Mailing Telephone | 6185484480 |
| Enumeration Date | 2016-07-07 |
| Last Update Date | 2016-07-07 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
019030831 | IL | Dental Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336787902 | Kyle Clark | Acupuncturist | 917 Sw Oak St Ste 308, Portland, OR 97205-2806 | 2019-12-13 |
| 1891955662 | Kyle Warner Clark | Dentist | 1008 Rushleigh Rd, Cleveland Heights, OH 44121-1415 | 2008-06-14 |
| 1922608926 | Kyle Clark | Pharmacist | 401 Linwood Plz, Lindsay, OK 73052-4602 | 2020-10-28 |
| 1427669480 | Kyle Clark | Behavior Technician | 1300 Locust St Ste C, Harrisonville, MO 64701-1366 | 2020-08-13 |
| 1750906533 | Kyle Clark | Behavior Technician | 13101 W Washington Blvd, Los Angeles, CA 90066-5131 | 2020-06-08 |
| 1801415864 | Kyle R Clark | Physician Assistant | 5666 E State St, Rockford, IL 61108-2425 | 2020-04-10 |
| 1376170613 | Kyle Clark | Physical Therapist | 3155 N Point Pkwy, Alpharetta, GA 30005-5481 | 2020-03-26 |
| 1669031829 | Kyle N Clark | Behavior Technician | 100 Spenryn Dr, Madison, AL 35758-1890 | 2019-06-11 |
| 1588134068 | Kyle Clark | Behavior Technician | 601 University Ave Ste 175, Sacramento, CA 95825-6739 | 2018-11-28 |
| 1679946057 | Kyle Clark | Pharmacist | 3780 E 15th St, Loveland, CO 80538-8766 | 2015-11-05 |
| Street Address |
113 CROSS CREEK BLVD |
| City | SALEM |
| State | IL |
| Zip Code | 62881-1921 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144364506 | Stanley E Morrison | Dentist | 113 Cross Creek Blvd, Salem, IL 62881-1921 | 2007-02-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447776026 | Heather Krajefska | Speech-Language Pathologist | Franklin Park School, 1325 N Franklin, Salem, IL 62881 | 2017-08-16 |
| 1629510581 | Heidi V. Thompson | Nurse Practitioner | 1250 W. Whittaker, Salem, IL 62881 | 2016-11-09 |
| 1548664170 | Catherine Durbin | Nurse Practitioner | 518 South Broadway, Salem, IL 62881 | 2014-10-10 |
| 1770718439 | Community Resource Center, Inc | Community/Behavioral Health | 315 Westgate, Salem, IL 62881 | 2009-05-26 |
| 1932377652 | Community Resource Center Inc | Clinic/Center | 315 Westgate Ave, Salem, IL 62881 | 2008-02-15 |
| 1245408053 | The Manor At Salem Woods, L.p. | Assisted Living Facility | 441 S. Hotze Rd., Salem, IL 62881 | 2008-02-14 |
| 1366610321 | Penta Group Inc. | Non-emergency Medical Transport (VAN) | 300 Schoonover Drive, Salem, IL 62881 | 2008-02-13 |
| 1326192808 | Alan D Montgomery | Optometrist | 400 North Broadway, Salem, IL 62881 | 2007-01-22 |
| 1669539979 | Knevitt Inc | Ambulance | 3340 Selmaville Rd, Salem, IL 62881 | 2007-01-03 |
| 1447314737 | Gautam Jha | Internal Medicine | 1325 W. Whittaker, Suite D, Salem, IL 62881 | 2006-12-20 |
| Find all providers in zip 62881 | ||||
| Taxonomy Code | 1223G0001X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | General Practice |
| 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. |
| Notes: Source: Academy of General Dentistry |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811557457 | Chadi Farag | Dentist | 25620 75th Street, Salem, WI 53168 | 2019-06-17 |
| 1528626660 | Stephanie Danielle Gibbons | Dentist | 5 Dawn St, Salem, NH 03079-3231 | 2019-06-04 |
| 1407414642 | Selma Moon Pierce | Dentist | 961 Glen Eden Ct Nw, Salem, OR 97304-2258 | 2019-06-03 |
| 1295392926 | Brock Jesse Nelson | Dentist | 631 Jason St Ne Ste 150, Salem, OR 97301-2750 | 2019-05-29 |
| 1023595899 | Gregory Lee Miller | Dentist | 3405 Derr Park Rd Se, Salem, OR 97310-0001 | 2018-07-25 |
| 1437643616 | Idylwood Dental LLC | Dentist | 4392 Liberty Road, Salem, OR 97302-6171 | 2018-06-20 |
| 1619428281 | William D. Bateman, Dmd, LLC | Dentist | 1995 Commercial St Se Ste 200, Salem, OR 97302-5291 | 2016-10-19 |
| 1134545494 | Caroline Wallace | Dentist | 103 S Colorado St, Salem, VA 24153-3848 | 2014-03-11 |
| 1275960296 | Amy Trevor | Dentist | 1595 Commercial St. Se, Salem, OR 97302 | 2013-10-04 |
| 1558601385 | Crisdental East Salem, LLC | Dentist | 3545 Lancaster Dr Ne, Salem, OR 97305-1435 | 2013-02-14 |
| Find all providers in SALEM | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.