Jeffrey Clark, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

7262 Issued in NE

Practice address

5709 NW Radial Hwy
Omaha, NE 68104-4141

Phone

(402) 551-1757

NPI assigned

Feb 6, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jclark639724@direct.ochin.org
• FHIR API: https://webprd.ochin.org/prd-fhir/allcarehealthcenter/api/FHIR/R4

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.

• All Care Health Center

  • Federally Qualified Health Center (FQHC)
  • Council Bluffs, IA
  • NPI 1114906906
  Medicare reassignment NPD
• All Care Health Center

  • Community/Retail Pharmacy
  • Council Bluffs, IA
  • NPI 1124461363
  NPD
• Richard D. Fitzgerald, DDS, PC

  • General Practice Dentistry
  • Omaha, NE
  • NPI 1932235645
  NPD (past)
• Willow Dental LLC

  • Dentist
  • Omaha, NE
  • NPI 1477227551
  NPD (past)

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

{
    "created_epoch": "1170720000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1778371200000",
    "number": "1407995426",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5709 NW RADIAL HWY",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681044141",
            "telephone_number": "402-551-1757"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5709 NW RADIAL HWY",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681044141",
            "telephone_number": "402-551-1757"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "902 S 6th St",
            "address_purpose": "LOCATION",
            "city": "Council Bluffs",
            "state": "IA",
            "postal_code": "515016441",
            "country_code": "US",
            "telephone_number": "712-325-1990",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CLARK",
        "first_name": "JEFFREY",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-06",
        "last_updated": "2026-05-10",
        "certification_date": "2026-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NE",
            "license": "7262",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gregory Clark
• Gwendolyn Elizabeth Clark, MD
• Jada Clark
• James Clark
• Jamirrah Aijanae Clark
• Jeffrey N Clark, D.C.
• Jennifer L Clark, APRN
• Jeremy Pat Clark
• Jermal Clark Jr.
• Jill Clark, CNA

• General Practice Dentistry in Omaha, NE
• Providers in Omaha, NE by specialty
• General Practice Dentistry in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.