DAKOTA CLARK (OD) – Optometrist, NPI 1528940087

DAKOTA CLARK (OD) is a healthcare provider. based in Owasso, Oklahoma. specializing in OPTOMETRY. They hold the professional credentials OD. They hold a License No. 3293 (OK). The NPI Number for DAKOTA CLARK (OD) is 1528940087

Main info

Male
Sole Proprietor
1 Year Of Experience
Accepts Medicare Assignment
Name
DAKOTA CLARK (OD)
NPI
1528940087
Phone
(918) 272-4900
Address
9021 N 121ST EAST AVE STE 100A
Enumeration Date
24 July 2025
Last Update Date
7 August 2025

Doctor Profile

Medical School Name
UNIVERSITY OF MISSOURI ST LOUIS - SCHOOL OF OPTOMETRY
Secondary Phone
9182724900
Graduation Year
2025 (1 year ago)
PAC ID
0244718070
Group Practice PAC ID
0143456319
Professional Enrollment ID
I20260303000073
Address ID
OK740555432OW9021XAVEX501
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience24
Completeness85
Years active:0State licenses:1Digital endpointsOther names

684 OPTOMETRY in OK

Provider Addresses for DAKOTA CLARK (OD)

  • 9021 N 121ST EAST AVE STE 100A

    OWASSO, OK 740555432

    Phone: (918) 272-4900

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2026-03-03

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20260303000073IOptometryOKTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 74055)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 0143456319View full group profile
NameSpecialtyState
-OK
O P T O M E T R YOK

Reviews

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Frequently asked questions

What is the registry number for DAKOTA CLARK (OD)?
The registry entry for DAKOTA CLARK (OD) shows NPI 1528940087.
Quick check: is DAKOTA CLARK (OD) active?
Public NPPES data shows DAKOTA CLARK (OD) with an active NPI status right now.
Which specialty label fits DAKOTA CLARK (OD)?
NPPES ties DAKOTA CLARK (OD) to Optometrist in the taxonomy section. Clinical services aligned with this taxonomy classification.
Which community is linked to DAKOTA CLARK (OD)?
DAKOTA CLARK (OD) shows a connection to Owasso, Oklahoma in registry-derived data.
Why is information missing for DAKOTA CLARK (OD)?
Providers choose how much contact data to publish. Missing fields do not mean the profile is fake.

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