D.S Park DDS, Inc

Primary specialty

DentistTaxonomy code 122300000X

License

53724 Issued in CA

Legal business name

D.S PARK DDS, INC

Doing business as

Madison Springs Dental Group

Practice address

25285 Madison Ave
107
Murrieta, CA 92562-8981

Phone

(951) 698-3585

Fax

(951) 698-3581

NPI assigned

Dec 11, 2013

Last updated

Dec 11, 2013By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

David Park, DDS

Title

Owner

Phone

(951) 698-3585

Specialties & licenses 1

Addresses

Other names 1

• Madison Springs Dental Group Doing business as

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

{
    "created_epoch": "1386720000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1386720000000",
    "number": "1043641319",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25285 MADISON AVE",
            "address_2": "107",
            "city": "MURRIETA",
            "state": "CA",
            "postal_code": "925628981",
            "telephone_number": "951-698-3585",
            "fax_number": "951-698-3581"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25285 MADISON AVE",
            "address_2": "107",
            "city": "MURRIETA",
            "state": "CA",
            "postal_code": "925628981",
            "telephone_number": "951-698-3585",
            "fax_number": "951-698-3581"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "D.S PARK DDS, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-12-11",
        "last_updated": "2013-12-11",
        "status": "A",
        "authorized_official_last_name": "PARK",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "951-698-3585",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "53724",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Madison Springs Dental Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Dentist in Murrieta, CA
• Providers in Murrieta, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2013; 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.