Active NPI
Sil Park, D.M.D.
- Prosthodontics
- Los Angeles, CA
National Provider Identifier
1477825677
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Prosthodontics
- License
- 59494
- Practice address
- 10833 Le Conte Ave RM A0-156B
UC Regents Maxillofacial Prosthetics
Los Angeles, CA 90095-1668 - Phone
- (310) 825-5889
- Fax
- (310) 825-6345
- NPI assigned
- Feb 2, 2012
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Prosthodontics | 1223P0700X | 59494 | CA | Primary |
Addresses
Primary practice location
10833 Le Conte Ave RM A0-156B
UC Regents Maxillofacial Prosthetics
Los Angeles, CA 90095-1668
Mailing address
10833 Le Conte Ave RM A0-156B
UC Regents Maxillofacial Prosthodontics
Los Angeles, CA 90095-1668
Phone (310) 825-5889
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 59494 | CA | MD | Surgical Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1328140800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1328140800000",
"number": "1477825677",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10833 LE CONTE AVE RM A0-156B",
"address_2": "UC REGENTS MAXILLOFACIAL PROSTHODONTICS",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900951668",
"telephone_number": "310-825-5889",
"fax_number": "310-825-6345"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10833 LE CONTE AVE RM A0-156B",
"address_2": "UC REGENTS MAXILLOFACIAL PROSTHETICS",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900951668",
"telephone_number": "310-825-5889",
"fax_number": "310-825-6345"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PARK",
"first_name": "SIL",
"name_prefix": "Dr.",
"credential": "D.M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2012-02-02",
"last_updated": "2012-02-02",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0700X",
"taxonomy_group": "",
"desc": "Dentist, Prosthodontics",
"state": "CA",
"license": "59494",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Los Angeles, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.