Allen K Park, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

21300 Issued in OH

Practice address

4859 Dover Center Rd
Suite 2
North Olmsted, OH 44070-3184

Phone

(440) 777-0177

Fax

(440) 777-8137

NPI assigned

Nov 11, 2006

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": "1163203200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1154492270",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4859 DOVER CENTER RD",
            "address_2": "SUITE 2",
            "city": "NORTH OLMSTED",
            "state": "OH",
            "postal_code": "440703184",
            "telephone_number": "440-777-0177",
            "fax_number": "440-777-8137"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4859 DOVER CENTER RD",
            "address_2": "SUITE 2",
            "city": "NORTH OLMSTED",
            "state": "OH",
            "postal_code": "440703184",
            "telephone_number": "440-777-0177",
            "fax_number": "440-777-8137"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "ALLEN",
        "middle_name": "K",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-11",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OH",
            "license": "21300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Otterbein North Olmsted LLC
• Our Family Cares
• Michelle Palmer
• John Anthony Panuto, MD
• Steven John Papandreas, DC
• Danielle Christine Pastor, DO
• Ankita Patel, APRN
• Pathway to Possibilities
• Allison Paton, PHARMD
• Paul W. Craven, M.D., Inc.

• General Practice Dentistry in North Olmsted, OH
• Providers in North Olmsted, OH by specialty
• General Practice Dentistry in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.