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Active NPI 1114052966 Individual Practitioner Male Practitioner

Dr. Bradley J Clark , DDS

Dentist - General Practice • Broken Bow, NE

Professional Overview & Biography Verified Profile Summary

Dr. Bradley Clark, DDS is a registered healthcare professional specializing in Dentist - General Practice in Broken Bow, NE. Practice services are available at 310 S 9TH AVE under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

310 S 9th Ave

Broken Bow, NE 688222014

Telephone 3088722575

Specialty Benchmarks & Practice Insights

Comparative analytics for Dentist - General Practice in Broken Bow, NE

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 19.2 Yrs
Regional Practice Density
2 Specialists

Practicing in Broken Bow, NE (832 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 NE 6126

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 Blue Cross Blue Shield #
5251 (NE)

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 310 S 9TH AVE, BROKEN BOW, NE 688222014 (Tel: 3088722575)

📍
Updated Business Mailing Address July 08, 2007

Registered at PO BOX 117, 310 SOUTH 9TH AVE., BROKEN BOW, NE 688220117 (Tel: 3088722575)

👤
Provider Name / Credentials Updated July 08, 2007

Recorded as BRADLEY CLARK, DDS

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

Dentist (License #6126 in NE)

🟢
Initial NPI Registration & Enumeration February 22, 2007

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: 1114052966
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: February 22, 2007
Last Update: July 08, 2007
Sole Proprietor: Yes
Update or Correct Profile

Mailing Address

Po Box 117, 310 South 9th Ave.

Broken Bow, NE 688220117

Phone: 3088722575

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.