Alexandra Park, D.M.D.

Primary specialty

DentistTaxonomy code 122300000X

License

DS039988 Issued in PA

Practice address

402 McFarlan Rd Ste 303
Kennett Square, PA 19348-2453

Phone

(610) 444-4033

NPI assigned

Feb 17, 2015

Sex

Female

Sole proprietor

Yes

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

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 and National Provider Directory roles.

• Kennett Dental Associates, PC

  • Dental Clinic/Center
  • Kennett Square, PA
  • NPI 1104658582
  NPD Authorized official
• Glenn Paskow & Richard Rem DMD PC

  • Dentist
  • Kennett Square, PA
  • NPI 1376658369
  NPD (past)

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

{
    "created_epoch": "1424131200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723680000000",
    "number": "1396136099",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "402 MCFARLAN RD STE 303",
            "city": "KENNETT SQUARE",
            "state": "PA",
            "postal_code": "193482453",
            "telephone_number": "610-444-4033"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "402 MCFARLAN RD STE 303",
            "city": "KENNETT SQUARE",
            "state": "PA",
            "postal_code": "193482453",
            "telephone_number": "610-444-4033"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "ALEXANDRA",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-02-17",
        "last_updated": "2024-08-15",
        "certification_date": "2024-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "PA",
            "license": "DS039988",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Wendy N Owen, M.S., CCC-SLP
• Matthew Pagano, D.O.
• Stephanie Palmeri, LPC, BSL
• Gail Lynn Panik, M.A., CCC-SLP
• Samantha Papps
• Josephine B Parncutt, RPH
• Matthew Pascarella, PT
• Glenn William Paskow, DMD
• Lindsey Pate
• Miraben K Patel, PT

• Dentist in Kennett Square, PA
• Providers in Kennett Square, PA by specialty
• Dentist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 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.