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Deactivated NPI 1083658983 Deactivated / Inactive NPI Male Practitioner

Dr. Robert F Clark , DDS

Dentist - General Practice • Everett, WA

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

Registration / Start Date June 15, 2006
NPI Deactivation Date March 13, 2018
Total Practice Duration ~12 Years of Practice (2006 – 2018)

Professional Overview & Biography Verified Profile Summary

Dr. Robert Clark, DDS was a registered Dentist - General Practice practicing in Everett, WA. Throughout an active medical career spanning 12 years, Dr. Clark provided care at the practice location at 5929 EVERGREEN WAY until profile deactivation on 2018-03-13.

Practice Location & Contact Primary Location

Practice Address

5929 Evergreen Way
Suite 101

Everett, WA 982036031

Telephone 4253534470
Fax 4253477416
Associated Practice Facility / Clinic

Specialty Benchmarks & Practice Insights

Comparative analytics for Dentist - General Practice in Everett, WA

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 21.3 Yrs
Regional Practice Density
83 Specialists

Practicing in Everett, WA (3345 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 WA DE00002494

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
NPI 1376548685

Doctor of Dental Medicine

Dr. Richard Clark , DDS

Dentist - General Practice

NPI 1376621508

Doctor of Dental Surgery

NPI 1447332655

Doctor of Osteopathic Medicine (D.O.)

Dr. Jae Hong , DDS

Dentist - Oral and Maxillofacial Surgery

NPI 1538257308

Doctor of Dental Surgery

Dr. Philip Clark , DDS

Dentist - General Practice

NPI 1629040183

Doctor of Dental Surgery

NPI 1740210681

Doctor of Philosophy (Ph.D.)

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 March 13, 2018

Record deactivated on March 13, 2018

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 5929 EVERGREEN WAY, SUITE 101, EVERETT, WA 982036031 (Tel: 4253534470)

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Updated Business Mailing Address July 08, 2007

Registered at 5929 EVERGREEN WAY, SUITE 101, EVERETT, WA 982036031 (Tel: 4253534470)

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Provider Name / Credentials Updated July 08, 2007

Recorded as ROBERT CLARK, DDS

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

Dentist (License #DE00002494 in WA)

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Initial NPI Registration & Enumeration June 15, 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: 1083658983
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: June 15, 2006
Last Update: July 08, 2007
Deactivation Date: March 13, 2018

Mailing Address

5929 Evergreen Way, Suite 101

Everett, WA 982036031

Phone: 4253534470

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.