Kelly Clark, DDS

General Practice Dentistry · Decatur, IL

Individual Active NPI

NPI number 1942379458

Practice location

3737 E Rte 36
Decatur, IL 62521-5028
Phone
(217) 423-2400
Fax
(217) 423-2460

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NPI record

NPI
1942379458
Entity type
Individual (Type 1)
Enumeration date
November 7, 2006
Last updated
June 15, 2026
Certified
June 15, 2026
Sole proprietor
No

Specialties & taxonomy codes

TaxonomyCodeLicenseState
General Practice Dentistry Primary 1223G0001X 019026315 IL

Mailing address

3737 E Route 36
Decatur, IL 62521
Phone
(217) 423-2400

About Dr. Clark

Kelly Clark, DDS is a healthcare provider registered in the NPI registry with the primary taxonomy General Practice Dentistry (code 1223G0001X). The practice location is 3737 E Rte 36, Decatur, IL 62521-5028. The NPI number 1942379458 was assigned on November 7, 2006 and the record was last updated on June 15, 2026.

Dr. Clark lists a license in the registry: #019026315 (IL) for General Practice Dentistry. License numbers are self-reported to NPPES; verify them with the state licensing board.

Frequently asked questions

What is the NPI number of Kelly Clark, DDS?

The NPI number is 1942379458.

What is the phone number of Dr. Clark?

The phone number listed for the practice location is (217) 423-2400.

Where is Dr. Clark located?

3737 E Rte 36, Decatur, IL 62521-5028.

What is the taxonomy code for Dr. Clark?

The primary taxonomy code is 1223G0001X – General Practice Dentistry.

Is this information correct?

All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.

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