Independent US Healthcare Provider Directory & Public Medical Database
Deactivated NPI 1124404322 Deactivated / Inactive NPI Male Practitioner

Dr. Reuben Leon Clark , DDS

Dentist - General Practice • Midvale, UT

⚠️

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

Registration / Start Date August 11, 2015
NPI Deactivation Date April 15, 2021
Total Practice Duration ~6 Years of Practice (2015 – 2021)

Professional Overview & Biography Verified Profile Summary

Dr. Reuben Clark, DDS was a registered Dentist - General Practice practicing in Midvale, UT. Throughout an active medical career spanning 6 years, Dr. Clark provided care at the practice location at 655 WEST CENTER STREET until profile deactivation on 2021-04-15.

Practice Location & Contact Primary Location

Practice Address

655 West Center Street

Midvale, UT 84047

Telephone 8012532141

Specialty Benchmarks & Practice Insights

Comparative analytics for Dentist - General Practice in Midvale, UT

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 22.8 Yrs
Regional Practice Density
22 Specialists

Practicing in Midvale, UT (1388 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 UT 133155-9921

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.

Career & Practice History Timeline

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

7 Historical Events
⚠️
NPI Profile Deactivated April 15, 2021

Record deactivated on April 15, 2021

NPI Profile Active August 11, 2015

NPI status registered as active in NPPES database

📍
Updated Practice Location August 11, 2015

Registered at 655 WEST CENTER STREET, MIDVALE, UT 84047 (Tel: 8012532141)

📍
Updated Business Mailing Address August 11, 2015

Registered at 655 WEST CENTER STREET, MIDVALE, UT 84047 (Tel: 8016470336)

👤
Provider Name / Credentials Updated August 11, 2015

Recorded as REUBEN CLARK, DDS

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) August 11, 2015

Dentist (License #133155-9921 in UT)

🟢
Initial NPI Registration & Enumeration August 11, 2015

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

0 Reviews
No patient reviews submitted yet for Dr. Reuben Clark. Be the first to share your experience!

Sign in to leave a review for Dr. Reuben Clark

Only verified registered users can submit ratings, post feedback, and upload facility photos.

NPI Administrative Meta

NPI Number: 1124404322
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: August 11, 2015
Last Update: August 11, 2015
Deactivation Date: April 15, 2021

Mailing Address

655 West Center Street

Midvale, UT 84047

Phone: 8016470336

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.