Jeffrey Clark, DMD in Council Bluffs, IA - Medicare Dentist Provider

Jeffrey Clark, DMD is a medicare enrolled "Dentist - General Practice" provider in Council Bluffs, Iowa. His current practice location is 902 S 6th St, Council Bluffs, Iowa. You can reach out to his office (for appointments etc.) via phone at (712) 325-1990.

Jeffrey Clark is licensed to practice in New Mexico (license number 12-2006) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1407995426.

Contact Information

	Jeffrey Clark, DMD
	902 S 6th St, Council Bluffs, IA 51501-6441
	(712) 325-1990
	Not Available

Map and Direction

Healthcare Provider's Profile

Full Name	Jeffrey Clark
Gender	Male
Speciality	Dentist - General Practice
Location	902 S 6th St, Council Bluffs, Iowa
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1407995426
Provider Enumeration Date: 02/06/2007
Last Update Date: 09/04/2024

Medicare PECOS Information:

PECOS PAC ID: 7315245362
Enrollment ID: I20220602000077

Medical Identifiers

Medical identifiers for Jeffrey Clark such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1407995426	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
1223G0001X	Dentist - General Practice	12-2006 (New Mexico)	Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Jeffrey Clark allows following entities to bill medicare on his behalf.

Entity Name	All Care Health Center
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1114906906 PECOS PAC ID: 0547241390 Enrollment ID: O20040527000070

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Jeffrey Clark is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Jeffrey Clark, DMD 902 S 6th St, Council Bluffs, IA 51501-6441 Ph: (712) 325-1990	Jeffrey Clark, DMD 902 S 6th St, Council Bluffs, IA 51501-6441 Ph: (712) 325-1990

Reviews and Comments

Dentist in Council Bluffs, IA

Dr. Kara Mullins, DDS Dentist Medicare: Medicare Enrolled Practice Location: 1026 Woodbury Ave, Council Bluffs, IA 51503 Phone: 712-847-8151
Dr. Edward B. Murray Jr., D.D.S. Dentist Medicare: Not Enrolled in Medicare Practice Location: 40 Northcrest Dr, Ste. 1, Council Bluffs, IA 51503 Phone: 712-328-9605 Fax: 712-328-9608
Zachary Dean Schufeldt, DDS Dentist Medicare: Medicare Enrolled Practice Location: 1860 Madison Ave Ste 4, Council Bluffs, IA 51503 Phone: 712-256-6263
Dr. Gary Alfred Smith, D.D.S. Dentist Medicare: Not Enrolled in Medicare Practice Location: 2612 W Broadway, Council Bluffs, IA 51501 Phone: 712-323-3615 Fax: 712-325-6155
Thomas Kimberly, DDS Dentist Medicare: Not Enrolled in Medicare Practice Location: 1509 Avenue G, Council Bluffs, IA 51501 Phone: 712-325-1544
Dr. Michael Anthony Rensch, DDS Dentist Medicare: Not Enrolled in Medicare Practice Location: 1601 Mcpherson Ave, Council Bluffs, IA 51503 Phone: 712-328-1810 Fax: 712-322-9857
William J Braymen, DDS Dentist Medicare: Medicare Enrolled Practice Location: 179 Bennett Ave, Council Bluffs, IA 51503 Phone: 712-322-2231 Fax: 712-322-6853

Jeffrey Clark, DMD - Medicare Dentist in Council Bluffs, IA