OrganizationActive
Bennie Clark Jr DMD PA
NPI 1295023752 · Dentist · Jacksonville, FL
Bennie Clark Jr DMD PA is a Dentist organization in Jacksonville, FL (NPI 1295023752).
Provider details
- NPI number
- 1295023752
- Entity type
- Organization
- Primary specialty
- DentistDental Providers
- Organization subpart
- No
- Authorized official
- Lorraine Clark, Vice President(904) 722-2200
Specialties & taxonomies
Dental Providers
- Dental Hygienist124Q00000X
Dental Providers
Profile Score
Detailed profile(82/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
15 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
5475 Soutel Dr
Jacksonville, FL 32219-3464
Phone: (904) 764-4576
Fax: (904) 722-9900
Street-level locationGet directions
Mailing address
5475 Soutel Dr
Jacksonville, FL 32219-3464
Other names (DBA / former)
- Doing business as
- Soutel Dental Center II
Registry dates
- Enumerated
- 2011-07-19
- Last updated
- 2019-11-01
Frequently asked questions
- What is Bennie Clark Jr DMD PA's NPI number?
- Bennie Clark Jr DMD PA's National Provider Identifier (NPI) is 1295023752, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Bennie Clark Jr DMD PA?
- Bennie Clark Jr DMD PA is classified in the NPPES registry as Dentist (Dental Providers).
- Where is Bennie Clark Jr DMD PA located?
- Bennie Clark Jr DMD PA's practice location on file with NPPES is 5475 Soutel Dr, Jacksonville, FL 32219-3464.
- What is Bennie Clark Jr DMD PA's phone number?
- The practice phone number listed in the NPPES registry for Bennie Clark Jr DMD PA is (904) 764-4576.
- Who is the authorized official for Bennie Clark Jr DMD PA?
- The authorized official listed on Bennie Clark Jr DMD PA's NPPES record is Lorraine Clark, Vice President. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Bennie Clark Jr DMD PA's NPI active?
- Yes — Bennie Clark Jr DMD PA's NPI (1295023752) is active in the NPPES registry as of the last update on 2019-11-01.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.