Active NPI
Brent Gilford Clark, DMD
- Orthodontics and Dentofacial Orthopedics Dentistry
- Betsy Layne, KY
National Provider Identifier
1508906751
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthodontics and Dentofacial Orthopedics Dentistry
- License
- 4980
- Practice address
- US 23 Hayes Complex
Betsy Layne, KY 41605-0001 - Phone
- (606) 478-9090
- Fax
- (606) 478-9191
- NPI assigned
- Feb 7, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 4980 | KY | |
| Orthodontics and Dentofacial Orthopedics Dentistry | 1223X0400X | 4980 | KY | Primary |
Addresses
Primary practice location
US 23 Hayes Complex
Betsy Layne, KY 41605-0001
Mailing address
PO Box 1
Betsy Layne, KY 41605-0001
Phone (606) 478-9090
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4980 | KY | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170806400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1757548800000",
"number": "1508906751",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1",
"city": "BETSY LAYNE",
"state": "KY",
"postal_code": "416050001",
"telephone_number": "606-478-9090",
"fax_number": "606-478-9191"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "US 23 HAYES COMPLEX",
"city": "BETSY LAYNE",
"state": "KY",
"postal_code": "416050001",
"telephone_number": "606-478-9090",
"fax_number": "606-478-9191"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CLARK",
"first_name": "BRENT",
"middle_name": "GILFORD",
"credential": "DMD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-02-07",
"last_updated": "2025-09-11",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "KY",
"license": "4980",
"primary": false
},
{
"code": "1223X0400X",
"taxonomy_group": "",
"desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
"state": "KY",
"license": "4980",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Betsy Layne, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.