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Active NPI 1194800946 Individual Practitioner Male Practitioner

Dr. Timothy Paul Clark , DDS

Dentist - General Practice • Becker, MN

Professional Overview & Biography Verified Profile Summary

Dr. Timothy Clark, DDS is a registered healthcare professional specializing in Dentist - General Practice in Becker, MN. Practice services are available at 12392 PLEASANT AVE. under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

12392 Pleasant Ave.

Becker, MN 553080098

Telephone 7632615350
Fax 7632625351

Specialty Benchmarks & Practice Insights

Comparative analytics for Dentist - General Practice in Becker, MN

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 33.3 Yrs
Regional Practice Density
1 Specialists

Practicing in Becker, MN (2262 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 MN 10140

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.

Additional State Medicaid & Healthcare Payer Identifiers

Commercial Insurance / Payer ID Bcbs Provider Number
6B403CL (MN)

Career & Practice History Timeline

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

6 Historical Events
✅
NPI Profile Active July 08, 2007

NPI status registered as active in NPPES database

📍
Updated Practice Location July 08, 2007

Registered at 12392 PLEASANT AVE., BECKER, MN 553080098 (Tel: 7632615350)

📍
Updated Business Mailing Address July 08, 2007

Registered at PO BOX 98, 12392 PLEASANT AVE., BECKER, MN 553080098 (Tel: 7632615350)

👤
Provider Name / Credentials Updated July 08, 2007

Recorded as TIMOTHY CLARK, DDS

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

Dentist (License #10140 in MN)

🟢
Initial NPI Registration & Enumeration October 26, 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: 1194800946
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: October 26, 2006
Last Update: July 08, 2007
Sole Proprietor: No
Update or Correct Profile

Mailing Address

Po Box 98, 12392 Pleasant Ave.

Becker, MN 553080098

Phone: 7632615350

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.