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Deactivated NPI 1548357429 Deactivated / Inactive NPI Male Practitioner

Dr. Paul Milligan Clark , DDS

Dentist - General Practice • Dayton, OH

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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. Paul Clark has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date October 10, 2006
NPI Deactivation Date January 28, 2022
Total Practice Duration ~16 Years of Practice (2006 – 2022)

Professional Overview & Biography Verified Profile Summary

Dr. Paul Clark, DDS was a registered Dentist - General Practice practicing in Dayton, OH. Throughout an active medical career spanning 16 years, Dr. Clark provided care at the practice location at 5045 N MAIN ST until profile deactivation on 2022-01-28.

Practice Location & Contact Primary Location

Practice Address

5045 N Main St
Suite 125

Dayton, OH 454153698

Telephone 9372774412
Fax 9372773626
Associated Practice Facility / Clinic
🏢 Walgreen Co Facility NPI 1972518991

Specialty Benchmarks & Practice Insights

Comparative analytics for Dentist - General Practice in Dayton, OH

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 19.6 Yrs
Regional Practice Density
102 Specialists

Practicing in Dayton, OH (4287 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 OH 30-019054

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

7 Associated Practitioners
Dr. Brian Wood , PsyD

Psychologist - Clinical

NPI 1225125172

Doctor of Psychology (Psy.D.)

Rita Rich , MA, CCC-SLP

Speech-Language Pathologist

NPI 1285776740

Master of Arts, Speech-Language Pathologist (Certificate of Clinical Competence)

NPI 1316918113

Doctor of Psychology (Psy.D.)

Todd Smedley

Non-emergency Medical Transport (VAN)

NPI 1538420880
Dr. Greg Vanarsdall , PsyD

Psychologist - Clinical

NPI 1841358785

Doctor of Psychology (Psy.D.)

NPI 1871330514

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 January 28, 2022

Record deactivated on January 28, 2022

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 5045 N MAIN ST, SUITE 125, DAYTON, OH 454153698 (Tel: 9372774412)

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Updated Business Mailing Address July 08, 2007

Registered at 5045 N MAIN ST, SUITE 125, DAYTON, OH 454153698 (Tel: 9372774412)

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Provider Name / Credentials Updated July 08, 2007

Recorded as PAUL CLARK, D.D.S.

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

Dentist (License #30-019054 in OH)

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Initial NPI Registration & Enumeration October 10, 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: 1548357429
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: October 10, 2006
Last Update: July 08, 2007
Deactivation Date: January 28, 2022

Mailing Address

5045 N Main St, Suite 125

Dayton, OH 454153698

Phone: 9372774412

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.