Park Prosthodontics, PLLC

Primary specialty

ProsthodonticsTaxonomy code 1223P0700X

Legal business name

PARK PROSTHODONTICS, PLLC

Practice address

50 Staniford St Ste 303
Boston, MA 02114-2542

Phone

(617) 523-4555

NPI assigned

May 4, 2021

Organization subpart

No

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

Authorized official

Name

Dr. Carly Park, DMDNPI 1942866900

Title

Owner

Phone

(203) 921-5437

Specialties & licenses 1

Addresses

Tax ID family

Park Prosthodontics PLLC2 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.

• Park Prosthodontics, PLLC

  • Prosthodontics
  • Boston, MA
  • NPI 1164078655
  NPD tax ID

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Carly F Park, DMD

  • Prosthodontics
  • Boston, MA
  • NPI 1942866900
  NPD Authorized official

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

{
    "created_epoch": "1620086400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1620086400000",
    "number": "1376126524",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "776 MAIN ST UNIT 540085",
            "city": "WALTHAM",
            "state": "MA",
            "postal_code": "024545405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 STANIFORD ST STE 303",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021142542",
            "telephone_number": "617-523-4555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PARK PROSTHODONTICS, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-05-04",
        "last_updated": "2021-05-04",
        "certification_date": "2021-05-04",
        "status": "A",
        "authorized_official_last_name": "PARK",
        "authorized_official_first_name": "CARLY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "203-921-5437",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223P0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Prosthodontics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sabrina Anastasia Parise, PA-C
• Kenneth M Pariser, MD
• Laura Marie Parisi
• Soja Park Bennett, MD
• Park Prosthodontics, PLLC
• Agnes Park, MD
• Carly F Park, DMD
• Chan-Shik Park, MD PHD
• Changhee Park, NP
• Charlie Chulhyun Park, MD

• Prosthodontics in Boston, MA
• Providers in Boston, MA by specialty
• Prosthodontics in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2021; 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.