Susan Lee Park, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

30806 Issued in CA

Practice address

2875 Middlefield Rd Ste 1
Palo Alto, CA 94306-2548

Phone

(650) 321-4035

Fax

(650) 321-2367

NPI assigned

Oct 26, 2006

Sex

Female

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

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

{
    "created_epoch": "1161820800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1306921515",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2875 MIDDLEFIELD RD STE 1",
            "city": "PALO ALTO",
            "state": "CA",
            "postal_code": "943062548",
            "telephone_number": "650-321-4035",
            "fax_number": "650-321-2367"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2875 MIDDLEFIELD RD STE 1",
            "city": "PALO ALTO",
            "state": "CA",
            "postal_code": "943062548",
            "telephone_number": "650-321-4035",
            "fax_number": "650-321-2367"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "SUSAN",
        "middle_name": "LEE",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "30806",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nicole Luanne Park, N.P.
• Rachel Park, WHCNP
• Roy Kiwan Park
• Shin Kwan Park
• Sung Mee Park, MD
• Woo Jung Park, L. AC
• Kelley R. Parke, PHD, LPCC
• Joshua A Parker
• Kate Parkinson, MFT
• Mary E Parman, DO

• General Practice Dentistry in Palo Alto, CA
• Providers in Palo Alto, 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 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.