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Active NPI 1649347097 Individual Practitioner Male Practitioner

Dr. Randolph Lynn Clark , DDS

Dentist - General Practice • Edmond, OK

Professional Overview & Biography Verified Profile Summary

Dr. Randolph Clark, DDS is a registered healthcare professional specializing in Dentist - General Practice in Edmond, OK. Practice services are available at 301 S BOULEVARD ST under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

301 S Boulevard St
Suite 118

Edmond, OK 730343878

Telephone 4053489182
Fax 4053301677
Associated Practice Facility / Clinic
🏢 R. Lynn Clark, D.d.s., P.c. Facility NPI 1134374507

Specialty Benchmarks & Practice Insights

Comparative analytics for Dentist - General Practice in Edmond, OK

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 17.8 Yrs
Regional Practice Density
71 Specialists

Practicing in Edmond, OK (1496 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 OK OK4992

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 Federal Tax I.d
73-137-9303 (OK)

Practice Associates & Co-Workers

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

1 Associated Practitioners
NPI 1669265864

Doctor of Dental Surgery

Career & Practice History Timeline

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

6 Historical Events
✅
NPI Profile Active December 26, 2008

NPI status registered as active in NPPES database

📍
Updated Practice Location December 26, 2008

Registered at 301 S BOULEVARD ST, SUITE 118, EDMOND, OK 730343878 (Tel: 4053489182)

📍
Updated Business Mailing Address December 26, 2008

Registered at 301 S BOULEVARD ST, SUITE 118, EDMOND, OK 730343878 (Tel: 4053489182)

👤
Provider Name / Credentials Updated December 26, 2008

Recorded as RANDOLPH CLARK, DDS

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) December 26, 2008

Dentist (License #OK4992 in OK)

🟢
Initial NPI Registration & Enumeration November 29, 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: 1649347097
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: November 29, 2006
Last Update: December 26, 2008
Sole Proprietor: Yes
Update or Correct Profile

Mailing Address

301 S Boulevard St, Suite 118

Edmond, OK 730343878

Phone: 4053489182

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.