Joseph Park, D.M.D.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DD4317 Issued in NM

Practice address

600 Texas St
Suite C
Clovis, NM 88101-9410

Phone

(575) 762-1900

NPI assigned

Jun 22, 2015

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NM

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

Practice roles (1 of 4)

Networks

• NM HMO C-SNP
• TX HMO D-SNP
• CO HMO D-SNP

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Kidskare P.C.

  • General Practice Dentistry
  • Las Cruces, NM
  • NPI 1316937964

  General Practice

  NPD (past)

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

{
    "created_epoch": "1434931200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1434931200000",
    "number": "1013399484",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 TEXAS ST",
            "address_2": "SUITE C",
            "city": "CLOVIS",
            "state": "NM",
            "postal_code": "881019410",
            "telephone_number": "575-762-1900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 TEXAS ST",
            "address_2": "SUITE C",
            "city": "CLOVIS",
            "state": "NM",
            "postal_code": "881019410",
            "telephone_number": "575-762-1900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "JOSEPH",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-06-22",
        "last_updated": "2015-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NM",
            "license": "DD4317",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• James Joseph Padilla
• Nicole Padilla
• Brittni D Page
• Kathy Paiz
• Monica Pando
• Kelly Parkey, LCSW
• Gwen Patriarca, SLP
• Patton Promise Home Care LLC
• Shameka Patton
• Samantha Paulison

• All providers in Clovis, NM
• General Practice Dentistry in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2015; 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.