Julia Park

Primary specialty

DentistTaxonomy code 122300000X

License

108370 Issued in CA

Practice address

5162 Whittier Blvd
East Los Angeles, CA 90022

Phone

(323) 415-6161

NPI assigned

Sep 1, 2022

Last updated

Apr 9, 2024By the provider in NPPES

Sex

Female

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

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Familia Dental River Glen LLC

  • Dental Clinic/Center
  • Milwaukee, WI
  • NPI 1154794584
  NPD
• Familia Dental River Glen LLC

  • Dental Clinic/Center
  • Milwaukee, WI
  • NPI 1285202978
  NPD
• Farhad Manavi Professional Dental Corporation

  dba West Coast Dental Group of East Los Angeles

  • General Practice Dentistry
  • Los Angeles, CA
  • NPI 1356565758
  NPD (past)

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

{
    "created_epoch": "1661990400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712620800000",
    "number": "1366162992",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18752 WILLOWTREE LN",
            "city": "NORTHRIDGE",
            "state": "CA",
            "postal_code": "913263900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5162 WHITTIER BLVD",
            "city": "EAST LOS ANGELES",
            "state": "CA",
            "postal_code": "90022",
            "telephone_number": "323-415-6161"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "142 E Capitol Dr",
            "address_purpose": "LOCATION",
            "city": "Milwaukee",
            "state": "WI",
            "postal_code": "532121206",
            "country_code": "US",
            "telephone_number": "414-444-1823",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PARK",
        "first_name": "JULIA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-09-01",
        "last_updated": "2024-04-09",
        "certification_date": "2024-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WI",
            "license": "6001079-15",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "108370",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mary Murillo
• Thaint Naing, MD
• Daryl Nava
• Anthony Nguyen, D.D.S.
• Melisa Guadalupe Osuna
• Policlinica Familiar San Judas Inc
• Ana Posada
• Blanca A. Quevedo
• Sergio Quirarte
• Adam Abraham Radwan

• Dentist in East Los Angeles, CA
• Providers in East Los Angeles, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2024; 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.