D S Park DDS MPH Inc

Primary specialty

DentistTaxonomy code 122300000X

Legal business name

D S PARK DDS MPH INC

Practice address

1120 Olivewood Dr
Merced, CA 95348

Phone

(209) 263-1505

NPI assigned

Jun 18, 2017

Organization subpart

No

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

Authorized official

Name

Brandi De Armon

Title

Regional Manager

Phone

(209) 325-4395

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Merced Dental Group Doing business as

Locations

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

{
    "created_epoch": "1497744000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1539648000000",
    "number": "1063942597",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1120 OLIVEWOOD DR",
            "city": "MERCED",
            "state": "CA",
            "postal_code": "953481210",
            "telephone_number": "209-325-4395"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1120 OLIVEWOOD DR",
            "city": "MERCED",
            "state": "CA",
            "postal_code": "95348",
            "telephone_number": "209-263-1505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "D S PARK DDS MPH INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-06-18",
        "last_updated": "2018-10-16",
        "status": "A",
        "authorized_official_last_name": "DE ARMON",
        "authorized_official_first_name": "BRANDI",
        "authorized_official_title_or_position": "REGIONAL MANAGER",
        "authorized_official_telephone_number": "209-325-4395"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1942410501",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Merced Dental Group",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Merced Dental Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Richard Kevin Cullen, LVN
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• Amanda Marie Curtice
• Robert Russell Cushing, DDS
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• Edward Dag, MD
• Bailey A Dahlhoff, DPT
• Christopher Robert Dahlhoff, P.T.

• All providers in Merced, CA
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2018; 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.