D Park DDS Inc

Primary specialty

DentistTaxonomy code 122300000X

License

53724 Issued in CA

Legal business name

D PARK DDS INC

Practice address

1130 Coffee Rd Ste 1a
Modesto, CA 95355-4228

Phone

(209) 523-5991

NPI assigned

Dec 31, 2012

Organization subpart

No

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

Authorized official

Name

David Park, DDS

Title

Owner

Phone

(310) 403-1117

Specialties & licenses 1

Addresses

Other names 1

• Coffee Dental Group Doing business as

Tax ID family

Coffee Dental Group2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Salida Dental Group

  • Dentist
  • Salida, CA
  • NPI 1407095599
  NPD tax ID

Locations

Practitioners 2

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

• Ricky Brar, D.D.S.

  • General Practice Dentistry
  • Modesto, CA
  • NPI 1639337660
  NPD (past)
• Trang Nguyen, DMD

  • General Practice Dentistry
  • San Jose, CA
  • NPI 1275159550
  NPD (past)

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

{
    "created_epoch": "1356912000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1356912000000",
    "number": "1174869796",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1130 COFFEE RD STE 1A",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953554228"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1130 COFFEE RD STE 1A",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953554228",
            "telephone_number": "209-523-5991"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "D PARK DDS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-12-31",
        "last_updated": "2012-12-31",
        "status": "A",
        "authorized_official_last_name": "PARK",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "310-403-1117",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "CA",
            "license": "53724",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Coffee Dental Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Travis Eddwin Curtiss, LMFT
• Pamela Ann Cushenberry Starks, M.D.
• Parker Cushing
• CVHH, Inc
• Cynthia E Gabert BSN, Rnfa
• D. Gordon Anderson, MD., Inc.
• Rosamani D'Souza, MD
• Sharon D'Souza, MD
• Terasa Lee Daffron
• Joseph Charles Dagostino, D.O.

• Dentist in Modesto, CA
• Providers in Modesto, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 31, 2012; 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.