Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1407360910 Individual Practitioner Female Practitioner

Dr. Grace Xinxing Clark , DDS

Dentist - General Practice • Fort Wayne, IN

Professional Overview & Biography Verified Profile Summary

Dr. Grace Clark, DDS is a registered healthcare professional specializing in Dentist - General Practice in Fort Wayne, IN. Practice services are available at 4716 ILLINOIS RD STE 101 under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

4716 Illinois Rd Ste 101

Fort Wayne, IN 468045123

Telephone 2604327970

Specialty Benchmarks & Practice Insights

Comparative analytics for Dentist - General Practice in Fort Wayne, IN

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 1.5 Yrs
State Avg: 14.3 Yrs
Regional Practice Density
148 Specialists

Practicing in Fort Wayne, IN (2204 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Dentist - General Practice Primary Specialty

NUCC Taxonomy Code: 1223G0001X

State License IN 12012818A

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.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

3 Associated Practitioners
NPI 1144846411

Doctor of Dental Medicine

NPI 1659972362

Doctor of Dental Surgery

NPI 1790389419

Doctor of Dental Medicine

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

11 Historical Events
NPI Profile Active January 12, 2018

NPI status registered as active in NPPES database

📍
Updated Practice Location January 12, 2018

Registered at 4716 ILLINOIS RD STE 101, FORT WAYNE, IN 468045123 (Tel: 2604327970)

📍
Updated Business Mailing Address January 12, 2018

Registered at 5120 BROOKSTONE WAY, INDIANAPOLIS, IN 462685417 (Tel: 8122516241)

👤
Provider Name / Credentials Updated January 12, 2018

Recorded as GRACE CLARK, DDS

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) January 12, 2018

Dentist (License #12012818A in IN)

NPI Profile Active November 20, 2017

NPI status registered as active in NPPES database

📍
Updated Practice Location November 20, 2017

Registered at 4716 ILLINOIS RD STE 101, FORT WAYNE, IN 468045123 (Tel: 2604327970)

📍
Updated Business Mailing Address November 20, 2017

Registered at 5120 BROOKSTONE WAY, INDIANAPOLIS, IN 462685417 (Tel: 8122516241)

👤
Provider Name / Credentials Updated November 20, 2017

Recorded as GRACE CLARK, DDS

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) November 20, 2017

Dentist (License #12012818A in IN)

🟢
Initial NPI Registration & Enumeration November 20, 2017

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1407360910
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: November 20, 2017
Last Update: January 12, 2018
Sole Proprietor: No

Mailing Address

5120 Brookstone Way

Indianapolis, IN 462685417

Phone: 8122516241

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.