Minerva C Park, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D13907 Issued in MN

Practice address

555 Wabasha St N Ste 250
Saint Paul, MN 55102-1673

Phone

(651) 292-9331

NPI assigned

Dec 5, 2017

Sex

Female

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1512432000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1512432000000",
    "number": "1033624655",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1160 CUSHING CIR APT 117",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551085010",
            "telephone_number": "443-857-4207"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "555 WABASHA ST N STE 250",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551021673",
            "telephone_number": "651-292-9331"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "MINERVA",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-12-05",
        "last_updated": "2017-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MN",
            "license": "D13907",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Juli A Park Jankowski, RPH
• Park Nicollet Health Care Products
• Christine Park, CPNP
• David Ji Hyun Park, DMD
• Hanbyul William Park, MD
• Tiffany Deborah Park, M.A., CCC-SLP
• Michelle Erin Parker
• Stephen Anthony Parker, PSYD LP
• Thomas Ward Parker
• Rachel Parkin, LICSW

• General Practice Dentistry in Saint Paul, MN
• Providers in Saint Paul, MN by specialty
• General Practice Dentistry in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.