Nicholas Parks, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

107721 Issued in CA

Practice address

370 Coddingtown Ctr
Santa Rosa, CA 95401-3507

Phone

(707) 867-1310

NPI assigned

Aug 4, 2022

Sex

Male

Sole proprietor

Yes

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)

Enrolled

State licenses

Practice roles

Locations

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.

• Bautista and Patel Dental

  • General Practice Dentistry
  • Santa Rosa, CA
  • NPI 1053982439
  NPD

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

{
    "created_epoch": "1659571200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659571200000",
    "number": "1306573969",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27840 CROWNE POINT DR",
            "city": "SALINAS",
            "state": "CA",
            "postal_code": "939081598",
            "telephone_number": "831-320-4874"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "370 CODDINGTOWN CTR",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954013507",
            "telephone_number": "707-867-1310"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARKS",
        "first_name": "NICHOLAS",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-08-04",
        "last_updated": "2022-08-04",
        "certification_date": "2022-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "107721",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Richard Parke
• Sophia Helena Parker-Fitzsimmons
• John C. Parker, MD
• Tracie Parker
• William Darwin Parker, DC
• Silja Parks
• Parkview Podiatry
• Danielle Marie Parra
• Medie Jesena Parrott, MSN, MPH
• Cheryl Parsley

• General Practice Dentistry in Santa Rosa, CA
• Providers in Santa Rosa, 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 Aug 4, 2022; 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.