Dr Paul Kenneth Clark Iii, DMD, MD in Twin Falls, ID

Dr Paul Kenneth Clark Iii, DMD, MD is a medicare enrolled "Dentist - Oral And Maxillofacial Surgery" provider in Twin Falls, Idaho. His current practice location is 1502 Locust St N Ste 103, Twin Falls, Idaho. You can reach out to his office (for appointments etc.) via phone at (208) 831-2900.

Dr Paul Kenneth Clark Iii is licensed to practice in Utah (license number 7829973-9922) 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 1689994923.

Contact Information

	Dr Paul Kenneth Clark Iii, DMD, MD
	1502 Locust St N Ste 103, Twin Falls, ID 83301-6375
	(208) 831-2900
	Not Available

Map and Direction

Healthcare Provider's Profile

Full Name	Dr Paul Kenneth Clark Iii
Gender	Male
Speciality	Dentist - Oral And Maxillofacial Surgery
Location	1502 Locust St N Ste 103, Twin Falls, Idaho
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1689994923
Provider Enumeration Date: 06/09/2010
Last Update Date: 11/15/2022

Medicare PECOS Information:

PECOS PAC ID: 1456772060
Enrollment ID: I20200608002472

Medical Identifiers

Medical identifiers for Dr Paul Kenneth Clark Iii such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1689994923	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
1223S0112X	Dentist - Oral And Maxillofacial Surgery	D-5108-OS (Idaho)	Secondary
1223S0112X	Dentist - Oral And Maxillofacial Surgery	7829973-9922 (Utah)	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. Dr Paul Kenneth Clark Iii allows following entities to bill medicare on his behalf.

Entity Name	Whitewater Oral Surgery Group Pllc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1104248053 PECOS PAC ID: 4789009473 Enrollment ID: O20200928002448

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. Dr Paul Kenneth Clark Iii 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
Dr Paul Kenneth Clark Iii, DMD, MD 1502 Locust St N Ste 103, Twin Falls, ID 83301-6375 Ph: (208) 831-2900	Dr Paul Kenneth Clark Iii, DMD, MD 1502 Locust St N Ste 103, Twin Falls, ID 83301-6375 Ph: (208) 831-2900

Reviews and Comments

Dentist in Twin Falls, ID

John Charles Roberts, D.D.S. Dentist Medicare: Not Enrolled in Medicare Practice Location: 256 Martin St., Twin Falls, ID 83301 Phone: 208-733-5346 Fax: 208-736-7082
Stephen Frederick Dixon, DDS Dentist Medicare: Medicare Enrolled Practice Location: 1218 Filer Ave E, Twin Falls, ID 83301 Phone: 208-733-4515 Fax: 208-733-2757
Dr. Jared Matthew Bitner, DDS Dentist Medicare: Not Enrolled in Medicare Practice Location: 590 Falls Ave, Twin Falls, ID 83301 Phone: 208-733-1182 Fax: 208-733-3341
Brett B Lund, DDS Dentist Medicare: Medicare Enrolled Practice Location: 325 Martin St Ste B, Twin Falls, ID 83301 Phone: 208-732-7447 Fax: 208-733-5940
Brian Rencher, DMD Dentist Medicare: Not Enrolled in Medicare Practice Location: 342 Blue Lakes Blvd N, Twin Falls, ID 83301 Phone: 208-734-8080
Dr. James Skousen, D.D.S. Dentist Medicare: Medicare Enrolled Practice Location: 532 Pole Line Rd, Twin Falls, ID 83301 Phone: 385-831-9151
Nathan Michael Peterson, DDS Dentist Medicare: Medicare Enrolled Practice Location: 452 Cheney Dr W Ste 150, Twin Falls, ID 83301 Phone: 855-433-6825

Dr Paul Kenneth Clark Iii, DMD, MD - Medicare Dentist in Twin Falls, ID