Zivin Park

Primary specialty

DentistTaxonomy code 122300000X

License

2901021641 Issued in MI

Practice address

5200 S Westnedge Ave
Portage, MI 49002

Phone

(269) 382-6656

NPI assigned

Jun 11, 2015

Last updated

Mar 26, 2021By the provider in NPPES

Sex

Male

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

Enrolled in MI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Dental Dreams PLLC

  • General Practice Dentistry
  • Portage, MI
  • NPI 1093122756
  NPD (past)

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

{
    "created_epoch": "1433980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616716800000",
    "number": "1124409560",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PMB 121-10001",
            "city": "SAIPAN",
            "state": "MP",
            "postal_code": "96950",
            "telephone_number": "670-235-2378"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5200 S WESTNEDGE AVE",
            "city": "PORTAGE",
            "state": "MI",
            "postal_code": "49002",
            "telephone_number": "269-382-6656"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "ZIVIN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-06-11",
        "last_updated": "2021-03-26",
        "certification_date": "2021-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MI",
            "license": "2901021641",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Manisha Tejal Parikh
• Park Allergy Center PC
• Jooheon Park, PHARMD
• Joon H Park, M.D.
• Michael Park, M.D.
• Matthew A Parker, O.D.
• Ashley Nicole Parkerson
• Allison Parrish
• Robert Earl Parsons Jr., MA, CRC, CVRT, LLPC
• Kelly J Pasch, FNP

• Dentist in Portage, MI
• Providers in Portage, MI by specialty
• Dentist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.