Cynthia Park, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

0401416554 Issued in VA

Practice address

8328 Traford LN Ste B
Springfield, VA 22152-1667

Phone

(703) 705-9660

NPI assigned

Aug 6, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in VA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1565049600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732579200000",
    "number": "1376198366",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14618 STREAM POND DR",
            "city": "CENTREVILLE",
            "state": "VA",
            "postal_code": "201202995",
            "telephone_number": "703-474-4761"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8328 TRAFORD LN STE B",
            "city": "SPRINGFIELD",
            "state": "VA",
            "postal_code": "221521667",
            "telephone_number": "703-705-9660"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "CYNTHIA",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-08-06",
        "last_updated": "2024-11-26",
        "certification_date": "2024-11-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "VA",
            "license": "0401416554",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gina Pak, PHARM.D
• Madelyn Palencia, RBT
• Pamir Healthcare Services, LLC
• Dimitrios Constantinos Papadouris, M.D.
• Edward S. Parelhoff, M.D.
• Jee Sook Park, MA, M.ED, BCBA
• Jennifer Park, M.D.
• Jinsil Park
• Natalie Park
• Sor Bi Park, DDS

• General Practice Dentistry in Springfield, VA
• Providers in Springfield, VA by specialty
• General Practice Dentistry in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.