Individual provider Active NPI

Sally Ann Keese Clark, D.D.S.

  • Dentist
  • Hot Springs, SD
National Provider Identifier
1124227335
Registry record updated Jan 22, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
7190 Issued in NE
Practice address
602 Jennings Ave
Hot Springs, SD 57747-1691
Phone
(605) 745-3975
NPI assigned
Jul 17, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 22, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 7190 NE Primary
General Practice Dentistry 1223G0001X D0630 SD

Addresses

Primary practice location

602 Jennings Ave
Hot Springs, SD 57747-1691

Mailing address

10740 S 98TH St
Lincoln, NE 68526-9463

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address Sally.Clark.p1@direct.bluestemlincoln.nextgenshare.com Bluestem Health

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
7190NEMDDentist
D0630SDMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Massa Dental Offices, PC General Practice Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1184630400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1769040000000",
    "number": "1124227335",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10740 S 98TH ST",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685269463"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "602 JENNINGS AVE",
            "city": "HOT SPRINGS",
            "state": "SD",
            "postal_code": "577471691",
            "telephone_number": "605-745-3975"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "SALLY",
        "middle_name": "ANN KEESE",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-17",
        "last_updated": "2026-01-22",
        "certification_date": "2026-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NE",
            "license": "7190",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "SD",
            "license": "D0630",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Sally.Clark.p1@direct.bluestemlincoln.nextgenshare.com",
            "affiliation": "Y",
            "affiliationName": "Bluestem Health",
            "address_1": "1021 N 27th St",
            "city": "Lincoln",
            "state": "NE",
            "country_code": "US",
            "postal_code": "685031803",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Hot Springs, SD

Sources for this page

Verify at the official NPI Registry.