Susan Park, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

32105 Issued in TX

Practice address

3607 Old Spanish TRL
Suite G
Houston, TX 77021

Phone

(281) 747-9500

NPI assigned

Jun 20, 2014

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1403222400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1478044800000",
    "number": "1104230838",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3607 OLD SPANISH TRL",
            "address_2": "SUITE G",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770212312",
            "telephone_number": "281-747-9500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3607 OLD SPANISH TRL",
            "address_2": "SUITE G",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "77021",
            "telephone_number": "281-747-9500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "SUSAN",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-06-20",
        "last_updated": "2016-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "63372",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "32105",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ryan J Park, MD
• Semyee Park, D.D.S
• Song Y. Park, NP-C
• Sung Hyun Park
• Sung-Hoon Park, MD
• Susanna Myrim Park, D.C.
• Tom Park
• Umi Park
• Victoria Yujung Park
• Yangseon Park, M.D.

• General Practice Dentistry in Houston, TX
• Providers in Houston, TX by specialty
• General Practice Dentistry in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2016; 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.