OrganizationActive
Kenneth C. Clark Dds,ms
NPI 1639568603 · Dental Clinic/Center · Green Bay, WI
Kenneth C. Clark Dds,ms is a Dental Clinic/Center organization in Green Bay, WI (NPI 1639568603).
Provider details
- NPI number
- 1639568603
- Entity type
- Organization
- Primary specialty
- Dental Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Kenneth Clark, Endodontist(920) 246-6118
- License
- 3707-15 (WI)
Specialties & taxonomies
Ambulatory Health Care Facilities
Profile Score
Established profile(74/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
11 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
2524 Hillside Heights Dr
Green Bay, WI 54311-6777
Phone: (920) 246-6118
Street-level locationGet directions
Mailing address
2524 Hillside Heights Dr
Green Bay, WI 54311-6777
Registry dates
- Enumerated
- 2015-01-14
- Last updated
- 2015-01-14
Frequently asked questions
- What is Kenneth C. Clark Dds,ms's NPI number?
- Kenneth C. Clark Dds,ms's National Provider Identifier (NPI) is 1639568603, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Kenneth C. Clark Dds,ms?
- Kenneth C. Clark Dds,ms is classified in the NPPES registry as Dental Clinic/Center (Ambulatory Health Care Facilities).
- Where is Kenneth C. Clark Dds,ms located?
- Kenneth C. Clark Dds,ms's practice location on file with NPPES is 2524 Hillside Heights Dr, Green Bay, WI 54311-6777.
- What is Kenneth C. Clark Dds,ms's phone number?
- The practice phone number listed in the NPPES registry for Kenneth C. Clark Dds,ms is (920) 246-6118.
- Who is the authorized official for Kenneth C. Clark Dds,ms?
- The authorized official listed on Kenneth C. Clark Dds,ms's NPPES record is Kenneth Clark, Endodontist. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Kenneth C. Clark Dds,ms's NPI active?
- Yes — Kenneth C. Clark Dds,ms's NPI (1639568603) is active in the NPPES registry as of the last update on 2015-01-14.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.