Active NPI
Wilhelmine Punsalan Park, DDS
- General Practice Dentistry
- Grand Prairie, TX
National Provider Identifier
1235344144
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 16989 TX
- Practice address
- 4709 S Robinson Rd
Grand Prairie, TX 75052-2147 - Phone
- (972) 262-3231
- Fax
- (972) 262-1317
- NPI assigned
- May 14, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 16989 TX | TX | Primary |
Addresses
Primary practice location
4709 S Robinson Rd
Grand Prairie, TX 75052-2147
Mailing address
4709 S Robinson Rd
Grand Prairie, TX 75052-2147
Phone (972) 262-3231
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 16989 TX | TX | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Christine P. Le, DDS PA | Past | Accepting new patients |
Organizations & group practices 1
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.
-
dba Family Dentistry of Grand Prairie
- Dental Clinic/Center
- Grand Prairie, TX
- NPI 1922928175
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179100800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1382918400000",
"number": "1235344144",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4709 S ROBINSON RD",
"city": "GRAND PRAIRIE",
"state": "TX",
"postal_code": "750522147",
"telephone_number": "972-262-3231",
"fax_number": "972-262-1317"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4709 S ROBINSON RD",
"city": "GRAND PRAIRIE",
"state": "TX",
"postal_code": "750522147",
"telephone_number": "972-262-3231",
"fax_number": "972-262-1317"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PARK",
"first_name": "WILHELMINE",
"middle_name": "PUNSALAN",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-05-14",
"last_updated": "2013-10-28",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "TX",
"license": "16989 TX",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Grand Prairie, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.