Mark Park, DDS

Primary specialty

EndodonticsTaxonomy code 1223E0200X

License

063880 Issued in NY

Practice address

60 Haven Ave
New York, NY 10032-2604

Phone

(212) 228-2663

NPI assigned

Sep 14, 2020

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

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": "1600041600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1786838400000",
    "number": "1134734353",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "60 HAVEN AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100322604",
            "telephone_number": "212-228-2663"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "60 HAVEN AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100322604",
            "telephone_number": "212-228-2663"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "MARK",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-09-14",
        "last_updated": "2026-08-16",
        "certification_date": "2026-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "NY",
            "license": "063880",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Leslie Park
• Leslie Ann Park, M.D.
• Lisa Park, M.D.
• Madeleine Park, PA-C
• Maria Fe Park, NP
• Michael Park, MD
• Michelle E Park, M.D.
• Mijung Park
• Minha Park, PT, DPT
• Minjung NMN Park, BCBA/LBA

• Endodontics in New York, NY
• Providers in New York, NY by specialty
• Endodontics in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 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.