David Park Dental Corp.

Primary specialty

DentistTaxonomy code 122300000X

License

53724 Issued in CA

Legal business name

DAVID PARK DENTAL CORP.

Practice address

3901 Madison Ave Ste 5
North Highlands, CA 95660-5095

Phone

(916) 999-0183

Fax

(916) 999-0908

NPI assigned

Jan 9, 2015

Organization subpart

No

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

Authorized official

Name

David Sangho Park, DDS

Title

Dentist/President

Phone

(916) 999-0183

Specialties & licenses 1

Addresses

Other names 1

• Highland Dental Group Doing business as

Locations

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

{
    "created_epoch": "1420761600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1420761600000",
    "number": "1326437666",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3901 MADISON AVE STE 5",
            "city": "NORTH HIGHLANDS",
            "state": "CA",
            "postal_code": "956605095",
            "telephone_number": "916-999-0183",
            "fax_number": "916-999-0908"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3901 MADISON AVE STE 5",
            "city": "NORTH HIGHLANDS",
            "state": "CA",
            "postal_code": "956605095",
            "telephone_number": "916-999-0183",
            "fax_number": "916-999-0908"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAVID PARK DENTAL CORP.",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-01-09",
        "last_updated": "2015-01-09",
        "status": "A",
        "authorized_official_last_name": "PARK",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "SANGHO",
        "authorized_official_title_or_position": "DENTIST/PRESIDENT",
        "authorized_official_telephone_number": "916-999-0183",
        "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": "Highland Dental Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Shaunda Crane, FNP
• Sandra Jean Cretney, MFTI
• Crosspoint Residential LLC
• Ryan Cumby, D.D.S.
• Nourollah Danialypour, MD
• Chakia Davies
• Andrea Dawson, PPS
• Desire Yvette Deane-Hanson, P.P.S./PASC
• Vicki Jean Dekay
• Drake Leonard Delaplane, MA

• Dentist in North Highlands, CA
• Providers in North Highlands, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2015; 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.