Tae Een Park,D.D.S.,Inc

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

License

56889 Issued in CA

Legal business name

TAE EEN PARK,D.D.S.,INC

Practice address

190 S Oak Ave Ste 6
Oakdale, CA 95361-3528

Phone

(209) 847-2800

Fax

(209) 847-2929

NPI assigned

Aug 31, 2015

Organization subpart

No

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

Authorized official

Name

Tae Een Park, DDSNPI 1447275375

Title

Ceo

Phone

(209) 847-2800

Specialties & licenses 1

Addresses

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Taeeen Park, D.D.S.

  • Dentist
  • Oakdale, CA
  • NPI 1447275375
  NPD Authorized official
• Pariya Manit, DDS

  • Dentist
  • Oakdale, CA
  • NPI 1861302937
  NPD (past)
• Simon Yakligian, DDS

  • General Practice Dentistry
  • Eugene, OR
  • NPI 1952324378
  NPD (past)

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

{
    "created_epoch": "1440979200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1440979200000",
    "number": "1063889558",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "190 S. OAK AVE BLDG 3 STE 6",
            "city": "OAKDALE",
            "state": "CA",
            "postal_code": "95361",
            "telephone_number": "209-847-2800",
            "fax_number": "209-847-2929"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "190 S OAK AVE STE 6",
            "city": "OAKDALE",
            "state": "CA",
            "postal_code": "953613528",
            "telephone_number": "209-847-2800",
            "fax_number": "209-847-2929"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TAE EEN PARK,D.D.S.,INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-08-31",
        "last_updated": "2015-08-31",
        "status": "A",
        "authorized_official_last_name": "PARK",
        "authorized_official_first_name": "TAE EEN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "209-847-2800",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "CA",
            "license": "56889",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stanislaus County
• Jenifer Stone, MASSAGE THERAPIST
• Rebekah Stout, FNP-C
• Shayne Strasser, PHARM.D.
• Suzanne Streater, MFT
• Taylor Behavior Therapy, LLC
• Taylor Consulting
• Steve Taylor, BCBA
• Taylor Taylor
• Kevin Michael Terry

• Dental Clinic/Center in Oakdale, CA
• Providers in Oakdale, CA by specialty
• Dental Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2015; 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.