Dr D S Park Dental Inc

Primary specialty

DentistTaxonomy code 122300000X

Legal business name

DR D S PARK DENTAL INC

Doing business as

Smile Dental of Delano

Practice address

1406 Jefferson St
Delano, CA 93215-2222

Phone

(661) 725-9430

Fax

(661) 725-7221

NPI assigned

Oct 23, 2019

Last updated

Jan 6, 2020By the provider in NPPES

Organization subpart

Yes

Parent organization

DR D S PARK DENTAL INCAs reported in NPPES

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

Authorized official

Name

David S Park, DDSNPI 1942410501

Title

Owner

Phone

(310) 403-1117

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Smile Dental of Delano Doing business as

Tax ID family

Dr D S Park Dental Inc2 organizations share this tax ID, including this one

Part of

Dr D S Park Dental Inc

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Dr D S Park Dental Inc

  dba Smile Dental of Wasco

  • Dentist
  • Wasco, CA
  • NPI 1760025589
  NPD tax ID

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• David S Park, DDS, MPH

  • General Practice Dentistry
  • Rancho Cordova, CA
  • NPI 1942410501
  Authorized official Same address or phone
• Brian Songsu Kim, D.M.D.

  • General Practice Dentistry
  • Delano, CA
  • NPI 1295868636
  NPD (past)
• Hanh Ngoc Nguyen, D.D.S.

  • General Practice Dentistry
  • Delano, CA
  • NPI 1730212952
  NPD (past)

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

{
    "created_epoch": "1571788800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1578268800000",
    "number": "1477196244",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1406 JEFFERSON ST",
            "city": "DELANO",
            "state": "CA",
            "postal_code": "932152222",
            "telephone_number": "661-725-9430",
            "fax_number": "661-725-7221"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1406 JEFFERSON ST",
            "city": "DELANO",
            "state": "CA",
            "postal_code": "932152222",
            "telephone_number": "661-725-9430",
            "fax_number": "661-725-7221"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR D S PARK DENTAL INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "DR D S PARK DENTAL INC",
        "enumeration_date": "2019-10-23",
        "last_updated": "2020-01-06",
        "certification_date": "2020-01-06",
        "status": "A",
        "authorized_official_last_name": "PARK",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "310-403-1117",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "53724",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Smile Dental of Delano",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Smile Dental of Delano",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Kayleigh Dill
• Anna Belinda Dimailig-David, M.D.
• Leila P Dingding, CRNA
• Nadine Domue
• Princess Marilyn Lagos Donato, PTA
• Veronica Duran-Perez, FNP
• Jennifer Duran
• Dva Healthcare Renal Care Inc (Delano Dialysis)
• Edward H. Gruber D.D.S.
• Edwin P. Ramirez, DDS, Inc.

• Dentist in Delano, CA
• Providers in Delano, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2020; 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.