Harold H Park, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

7112 Issued in AZ

Practice address

5504 E 22ND St
Tucson, AZ 85711-5540

Phone

(520) 526-0531

NPI assigned

Nov 2, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1162425600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560211200000",
    "number": "1336228451",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6651 N CAMPBELL AVE APT 135",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857181361",
            "telephone_number": "520-275-8044"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5504 E 22ND ST",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857115540",
            "telephone_number": "520-526-0531"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "724 W Main St Ste 316",
            "address_purpose": "LOCATION",
            "city": "Lewisville",
            "state": "TX",
            "postal_code": "750673566",
            "country_code": "US",
            "telephone_number": "520-275-8044",
            "fax_number": "678-285-4837",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PARK",
        "first_name": "HAROLD",
        "middle_name": "H",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-02",
        "last_updated": "2019-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "34571",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AZ",
            "license": "7112",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Park Family Medicine LLC
• Park Waverly Healthcare LLC
• Park Waverly Healthcare LLC
• Eun Soo David Park, M.D.
• Grace Hyeyoung Park
• Jay K. Park, M.D.
• Jenna J Park, DMD
• Ji Eun Park, MD, MA
• Sean Park, PHARMD
• Shinhye Chloe Park

• General Practice Dentistry in Tucson, AZ
• Providers in Tucson, AZ by specialty
• General Practice Dentistry in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2019; 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.