Griffin Davis Park, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

33671 Issued in TX

Practice address

5656 Edwards Ranch Rd Ste 101
Fort Worth, TX 76109-4105

Phone

(817) 731-9487

NPI assigned

Aug 23, 2017

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

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.

• RMS DDS, PLLC

  • Dentist
  • Fort Worth, TX
  • NPI 1669019782
  NPD
• Reese Dental at Lake Country, PLLC

  • General Practice Dentistry
  • Fort Worth, TX
  • NPI 1487010591
  NPD (past)

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

{
    "created_epoch": "1503446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746489600000",
    "number": "1427575307",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5656 EDWARDS RANCH RD STE 101",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761094105",
            "telephone_number": "817-731-9487"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5656 EDWARDS RANCH RD STE 101",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761094105",
            "telephone_number": "817-731-9487"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "GRIFFIN",
        "middle_name": "DAVIS",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-08-23",
        "last_updated": "2025-05-06",
        "certification_date": "2025-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "NV",
            "license": "6943",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TX",
            "license": "33671",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TEXAS STATE BOARD",
            "identifier": "33671",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Park View SNF LLC (Park View Care Center)
• Chad C Park, DDS
• Charlie Joon Park, CRNA
• Clinton Sangkyu Park, M.D.
• Glynis Park, MS
• James T. Park, APRN,FNP-C,DC
• Jericho Bryan Park, MD
• Michael Park, DDS
• Miran Park
• Namsoon Park, MS

• Dentist in Fort Worth, TX
• Providers in Fort Worth, TX by specialty
• Dentist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2025; 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.