NPIMap

Organization Active NPI

James Park D.M.D

  • General Practice Dentistry
  • Southbridge, MA
National Provider Identifier
1366936841
Registry record updated Jun 19, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DN1856630 Issued in MA
Legal business name
JAMES PARK D.M.D
Practice address
44 Everett St
Southbridge, MA 01550-2620
Phone
(508) 764-4600
Fax
(508) 765-5862
NPI assigned
Jun 19, 2018
Last updated
Jun 19, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 19, 2018

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

Authorized official

Name
Dr. James Park, D.M.DNPI 1841553880
Title
Dentist
Phone
(508) 764-4600

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X DN1856630 MA Primary

Addresses

Primary practice location

44 Everett St
Southbridge, MA 01550-2620

Mailing address

44 Everett St
Southbridge, MA 01550-2620
Phone (508) 764-4600

Other names 1

  • James Park D.M.D Former legal business name

National Provider Directory

National Provider Directory
Tax ID family
James Park DMD2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

44 Everett St
Southbridge, MA 01550
Phone (508) 764-4600

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1529366400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1529366400000",
    "number": "1366936841",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "44 EVERETT ST",
            "city": "SOUTHBRIDGE",
            "state": "MA",
            "postal_code": "015502620",
            "telephone_number": "508-764-4600",
            "fax_number": "508-765-5862"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "44 EVERETT ST",
            "city": "SOUTHBRIDGE",
            "state": "MA",
            "postal_code": "015502620",
            "telephone_number": "508-764-4600",
            "fax_number": "508-765-5862"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JAMES PARK D.M.D",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-06-19",
        "last_updated": "2018-06-19",
        "status": "A",
        "authorized_official_last_name": "PARK",
        "authorized_official_first_name": "JAMES",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "508-764-4600",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.M.D"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "MA",
            "license": "DN1856630",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "James Park D.M.D",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "James Park D.M.D",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Southbridge, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2018; 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.