Park Station Dental Group

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

4206 Issued in TN

Legal business name

PARK STATION DENTAL GROUP

Practice address

5180 Park Ave
Suite 310
Memphis, TN 38119-3521

Phone

(901) 685-1152

Fax

(901) 682-6846

NPI assigned

Feb 3, 2009

Organization subpart

No

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

Authorized official

Name

Dr. Milton Siskin Jr., D.D.S.

Title

Owner / Dentist

Phone

(901) 685-1152

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1233619200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1233619200000",
    "number": "1407094121",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5180 PARK AVE",
            "address_2": "SUITE 310",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381193521",
            "telephone_number": "901-685-1152",
            "fax_number": "901-682-6846"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5180 PARK AVE",
            "address_2": "SUITE 310",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381193521",
            "telephone_number": "901-685-1152",
            "fax_number": "901-682-6846"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PARK STATION DENTAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-02-03",
        "last_updated": "2009-02-03",
        "status": "A",
        "authorized_official_last_name": "SISKIN",
        "authorized_official_first_name": "MILTON",
        "authorized_official_title_or_position": "OWNER / DENTIST",
        "authorized_official_telephone_number": "901-685-1152",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "TN",
            "license": "4206",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "4031894",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Poojan Anandbhai Parikh, MD
• Andrea Marie Parish, MA, BCBA
• Jada Alexius Parish
• Park Avenue Emergency Physicians
• Park Highland Medical Clinic, PLLC
• Julia Park, LMSW
• Julie Ruggieri Park, MD
• Karen Sophia Park, MD
• Paul Park, MD
• Angel C Parker-Heffner, MSN APRN FNP-C

• General Practice Dentistry in Memphis, TN
• Providers in Memphis, TN by specialty
• General Practice Dentistry in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2009; 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.