Evergreen Family Dentistry

Primary specialty

DentistTaxonomy code 122300000X

Legal business name

EVERGREEN FAMILY DENTISTRY

Practice address

17798 147TH St SE
Monroe, WA 98272-1030

Phone

(360) 805-0211

NPI assigned

Mar 24, 2026

Organization subpart

No

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

Authorized official

Name

Dr. Robert Park, DDSNPI 1477639375

Title

Owner Dentist

Phone

(360) 805-0211

Specialties & licenses 1

Addresses

Practitioners 1

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

• Robert K Park, D.D.S.

  • General Practice Dentistry
  • Monroe, WA
  • NPI 1477639375
  NPD Authorized official

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

{
    "created_epoch": "1774310400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1774310400000",
    "number": "1124966544",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17798 147TH ST SE",
            "city": "MONROE",
            "state": "WA",
            "postal_code": "982721030",
            "telephone_number": "360-805-0211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17798 147TH ST SE",
            "city": "MONROE",
            "state": "WA",
            "postal_code": "982721030",
            "telephone_number": "360-805-0211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVERGREEN FAMILY DENTISTRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-03-24",
        "last_updated": "2026-03-24",
        "certification_date": "2026-03-24",
        "status": "A",
        "authorized_official_last_name": "PARK",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "OWNER DENTIST",
        "authorized_official_telephone_number": "360-805-0211",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Emily Estrada
• Kaylee Redelle Evans, LMT
• Roger Evans
• Taylor Evans
• Dawn Michelle Evarts, LAC, EAMP
• Evergreen Family Dentistry
• Evergreen Family Dentistry, Inc.
• Roxanne Fairfax, LMT
• Carson Farmer
• Sarah Elizabth Farretta, CPC

• Dentist in Monroe, WA
• Providers in Monroe, WA by specialty
• Dentist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2026; 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.