Independent US Healthcare Provider Directory & Public Medical Database
Deactivated NPI 1972677201 Deactivated / Inactive NPI Male Practitioner

Dr. Robert J Clark , DDS

Dentist • Mandeville, LA

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Dr. Robert Clark has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date November 20, 2006
NPI Deactivation Date November 26, 2021
Total Practice Duration ~15 Years of Practice (2006 – 2021)

Professional Overview & Biography Verified Profile Summary

Dr. Robert Clark, DDS was a registered Dentist practicing in Mandeville, LA. Throughout an active medical career spanning 15 years, Dr. Clark provided care at the practice location at 639 LOTUS DR N until profile deactivation on 2021-11-26.

Practice Location & Contact Primary Location

Practice Address

639 Lotus Dr N

Mandeville, LA 70471

Telephone 9856245449
Fax 9856740393
Associated Practice Facility / Clinic
🏢 Clark Family Dentistry Facility NPI 1891896148

Specialty Benchmarks & Practice Insights

Comparative analytics for Dentist in Mandeville, LA

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 17.7 Yrs
Regional Practice Density
19 Specialists

Practicing in Mandeville, LA (964 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 Primary Specialty

NUCC Taxonomy Code: 122300000X

State License LA 1495

A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist.

Practice Associates & Co-Workers

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

1 Associated Practitioners
Dr. Paul Clark , DDS

Dentist - General Practice

NPI 1184872947

Doctor of Dental Surgery

Career & Practice History Timeline

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

7 Historical Events
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NPI Profile Deactivated November 26, 2021

Record deactivated on November 26, 2021

NPI Profile Active July 08, 2007

NPI status registered as active in NPPES database

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Updated Practice Location July 08, 2007

Registered at 639 LOTUS DR N, MANDEVILLE, LA 70471 (Tel: 9856245449)

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Updated Business Mailing Address July 08, 2007

Registered at 639 LOTUS DR N, MANDEVILLE, LA 70471 (Tel: 9856245449)

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Provider Name / Credentials Updated July 08, 2007

Recorded as ROBERT CLARK, DDS

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Medical Taxonomy / Specialty Registered (Primary Specialty) July 08, 2007

Dentist (License #1495 in LA)

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Initial NPI Registration & Enumeration November 20, 2006

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: 1972677201
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: November 20, 2006
Last Update: July 08, 2007
Deactivation Date: November 26, 2021

Mailing Address

639 Lotus Dr N

Mandeville, LA 70471

Phone: 9856245449

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.