Shannon Carol Clark, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

2020005163 Issued in MO

Practice address

1411 S Range Line Rd
Joplin, MO 64801-5589

Phone

(417) 541-2666

NPI assigned

Apr 25, 2008

Last updated

Mar 18, 2026By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1209081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773792000000",
    "number": "1922273481",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1411 S RANGE LINE RD",
            "city": "JOPLIN",
            "state": "MO",
            "postal_code": "648015589",
            "telephone_number": "417-541-2666"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1411 S RANGE LINE RD",
            "city": "JOPLIN",
            "state": "MO",
            "postal_code": "648015589",
            "telephone_number": "417-541-2666"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "SHANNON",
        "middle_name": "CAROL",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-04-25",
        "last_updated": "2026-03-18",
        "certification_date": "2026-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MO",
            "license": "2020005163",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "KS",
            "license": "62065",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "AR",
            "license": "3142",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cali Clark, DO, MBA
• Daniel Charles Clark, MSW
• Katherine Somers Clark, MS,RDN,CNSC,LD
• Kelly Clark, MS, CCC-SLP
• Matthew Joseph Clark
• Megan Dawn Clarkin, D.O.
• Morgan Claybrook
• James Arthur Clement, ED.S,L.P.C., NCC
• Joyce Clement, NP
• Ali Drew Cleveland, COTA/L

• Dentist in Joplin, MO
• Providers in Joplin, MO by specialty
• Dentist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2026; 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.