Rachel Hayes Clark, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

61349 Issued in KS

Practice address

1122 N Topeka St
Wichita, KS 67214-2810

Phone

(316) 866-2000

NPI assigned

May 30, 2018

Sex

Female

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Illuminate Family Dentistry, LLC

  • General Practice Dentistry
  • Derby, KS
  • NPI 1316691736
  NPD Authorized official

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

{
    "created_epoch": "1527638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1527638400000",
    "number": "1720570484",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2113 N WOODARD ST",
            "city": "DERBY",
            "state": "KS",
            "postal_code": "670372364",
            "telephone_number": "316-207-7381"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1122 N TOPEKA ST",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672142810",
            "telephone_number": "316-866-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "RACHEL",
        "middle_name": "HAYES",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-05-30",
        "last_updated": "2018-05-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "KS",
            "license": "61349",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Katharine Clark, CRNA
• Katherine Nicole Clark
• Kayla J Clark
• Kenzie Clark
• Mark Clark
• Richard Glenn Clark, DMD
• Taylor Clark
• Thomas Colin Clark, PT
• Vivienne Violet Clark, LMSW
• Jacob Daniel Clarke, MD

• Dentist in Wichita, KS
• Providers in Wichita, KS by specialty
• Dentist in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.