Rodney Kim Park, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

CA 37477 Issued in CA

Practice address

6146 Camino Verde Dr
Suite O
San Jose, CA 95119-1460

Phone

(408) 224-7878

Fax

(408) 224-3067

NPI assigned

Jul 10, 2007

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

Practice roles

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

• Rodney K. Park, DDS, Inc.

  dba Rodney K. Park, DDS

  • General Practice Dentistry
  • San Jose, CA
  • NPI 1083448633
  NPD (past)

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

{
    "created_epoch": "1184025600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1184025600000",
    "number": "1144428194",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6146 CAMINO VERDE DR",
            "address_2": "SUITE O",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951191460",
            "telephone_number": "408-224-7878",
            "fax_number": "408-224-3067"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6146 CAMINO VERDE DR",
            "address_2": "SUITE O",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951191460",
            "telephone_number": "408-224-7878",
            "fax_number": "408-224-3067"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "RODNEY",
        "middle_name": "KIM",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-07-10",
        "last_updated": "2007-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "CA 37477",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mi Ran Park, M.D.
• Misuk Park
• Nam Hee Ava Park, DDS
• Natalie Park, O.T.
• Olivia Park, PHARMACIST
• So Young Park, D.D.S.
• Sun Ja Park, D.C
• Tom S. Park, D.D.S.
• Uriel Park
• Yun Sang Park, O.D.

• General Practice Dentistry in San Jose, CA
• Providers in San Jose, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2007; 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.