Haeri Park, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

2901022710 Issued in MI

Practice address

22541 Gratiot Ave
Eastpointe, MI 48021-2360

Phone

(586) 777-0001

NPI assigned

Jun 13, 2018

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

Practice roles

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.

• Dental Dreams PLLC

  • General Practice Dentistry
  • Eastpointe, MI
  • NPI 1407263163
  NPD (past)

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

{
    "created_epoch": "1528848000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1528848000000",
    "number": "1073006102",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "350 N CLARK ST FL 6",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606544712"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22541 GRATIOT AVE",
            "city": "EASTPOINTE",
            "state": "MI",
            "postal_code": "480212360",
            "telephone_number": "586-777-0001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "HAERI",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-13",
        "last_updated": "2018-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "2901022710",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pace Southeast Michigan
• Stephen James Palajac, DPM
• Katherine Anne Paquette, ACNP
• Monica Lynn Parham-Contejean, RD
• Natasha Christina Paris
• Janghoon Park
• Dale Parson Jr., PTA
• Brandi Pate-Brown
• Jitendrakumar Patel, PHARMACIST
• Poonam Patel, M.D.

• General Practice Dentistry in Eastpointe, MI
• Providers in Eastpointe, MI by specialty
• General Practice Dentistry in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 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.