D Park Professional Dental Corp

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

53724 Issued in CA

Legal business name

D PARK PROFESSIONAL DENTAL CORP

Doing business as

Children & Adult Dentistry- Santa Ana

Practice address

512 W 17TH St Ste B
Santa Ana, CA 92706-3678

Phone

(714) 210-0169

Fax

(714) 972-0162

NPI assigned

May 12, 2018

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

(714) 210-0169

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Children & Adult Dentistry- Santa Ana Doing business as

Locations

Practitioners 1

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

• Cynthia Le, DDS

  • Dentist
  • Santa Ana, CA
  • NPI 1780773028
  NPD (past)

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

{
    "created_epoch": "1526083200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1526083200000",
    "number": "1194215442",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "512 W 17TH ST STE B",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927063678",
            "telephone_number": "714-210-0169",
            "fax_number": "714-972-0162"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "512 W 17TH ST STE B",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927063678",
            "telephone_number": "714-210-0169",
            "fax_number": "714-972-0162"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "D PARK PROFESSIONAL DENTAL CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-05-12",
        "last_updated": "2018-05-12",
        "status": "A",
        "authorized_official_last_name": "PARK",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "714-210-0169",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "53724",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "53724",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Children & Adult Dentistry- Santa Ana",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Children & Adult Dentistry- Santa Ana",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Ma Angelica Cuyugan
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• Czapla Chiropractic Inc.
• Jason Russel D'Amico, LPT
• Austin Sage D'Amond
• Cynthia C D'Arnaud-Guerre
• Jessica Jean D'Heilly, BEHAVIOR THERAPIST
• Jena D'Souza

• General Practice Dentistry in Santa Ana, CA
• Providers in Santa Ana, 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 May 12, 2018; 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.