David Y Park, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

105049 Issued in CA

Practice address

1331 Crane St.
Unit 413
Menlo Park, CA 94025

Phone

(425) 224-6598

NPI assigned

Feb 26, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Interoperability endpoints

• Direct secure messaging: david.park.d1.p1@direct.macthealth.nextgenshare.com
• Direct secure messaging: david.park.p1@direct.csvs.nextgenshare.com
• FHIR API: https://fhir4.healow.com/fhir/r4/AECBBA/Endpoint/AECBBA

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

{
    "created_epoch": "1172448000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725321600000",
    "number": "1013043777",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1331 CRANE ST.",
            "address_2": "UNIT 413",
            "city": "MENLO PARK",
            "state": "CA",
            "postal_code": "94025",
            "telephone_number": "425-224-6598"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1331 CRANE ST.",
            "address_2": "UNIT 413",
            "city": "MENLO PARK",
            "state": "CA",
            "postal_code": "94025",
            "telephone_number": "425-224-6598"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2540 Sister Mary Columba Dr",
            "address_purpose": "LOCATION",
            "city": "Red Bluff",
            "state": "CA",
            "postal_code": "960804327",
            "country_code": "US",
            "telephone_number": "530-690-2827",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PARK",
        "first_name": "DAVID",
        "middle_name": "Y",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-26",
        "last_updated": "2024-09-03",
        "certification_date": "2024-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WA",
            "license": "DE7629",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "105049",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Palo Alto Vamc
• Palo Alto Vamc
• Demetra Paras, MA, MFT
• Ferdinand650 D Parcasio
• George L Paris, MD
• Mimi Park, MS, CCC-SLP
• Negar Parravi, DDS
• Alia Hiroko Parvez, PT
• Christopher John Pascual, OTR/L
• Leigh Scanlon Patalay, PSYD

• Dentist in Menlo Park, CA
• Providers in Menlo Park, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.