NPIMap

Organization Active NPI

Clinton Park Dental Corporation

  • General Practice Dentistry
  • Carlsbad, CA
National Provider Identifier
1083848568
Registry record updated Aug 19, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
CLINTON PARK DENTAL CORPORATION
Practice address
2635 Gateway Rd
Suite 101
Carlsbad, CA 92009-1753
Phone
(760) 431-8112
Fax
(760) 929-8776
NPI assigned
May 12, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2013

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

Authorized official

Name
Dr. Clinton H Park, DDS
Title
Owner Doctor
Phone
(760) 431-8112

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

2635 Gateway Rd
Suite 101
Carlsbad, CA 92009-1753

Mailing address

17000 Red Hill Ave
Irvine, CA 92614-5626
Phone (714) 845-8890

Other names 1

  • Gateway Dental Group and Orthodontics Doing business as

National Provider Directory

National Provider Directory

Locations

2635 Gateway Rd
Ste 101
Carlsbad, CA 92009
Phone (760) 431-8112

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1242086400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1376870400000",
    "number": "1083848568",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17000 RED HILL AVE",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926145626",
            "telephone_number": "714-845-8890",
            "fax_number": "949-474-1495"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2635 GATEWAY RD",
            "address_2": "SUITE 101",
            "city": "CARLSBAD",
            "state": "CA",
            "postal_code": "920091753",
            "telephone_number": "760-431-8112",
            "fax_number": "760-929-8776"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLINTON PARK DENTAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-05-12",
        "last_updated": "2013-08-19",
        "status": "A",
        "authorized_official_last_name": "PARK",
        "authorized_official_first_name": "CLINTON",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "OWNER DOCTOR",
        "authorized_official_telephone_number": "760-431-8112",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Gateway Dental Group and Orthodontics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Carlsbad, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 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.