Evergreen Family Dentistry Bellevue

Primary specialty

DentistTaxonomy code 122300000X

Legal business name

EVERGREEN FAMILY DENTISTRY BELLEVUE

Practice address

15615 Bel Red Rd Ste D
Bellevue, WA 98008-2300

Phone

(425) 643-6072

NPI assigned

Mar 24, 2026

Last updated

Mar 24, 2026By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Robert Park, DDSNPI 1477639375

Title

Owner Dentist

Phone

(425) 643-6072

Specialties & licenses 1

Addresses

Locations

Practitioners 2

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.

• Robert K Park, D.D.S.

  • General Practice Dentistry
  • Monroe, WA
  • NPI 1477639375
  NPD Authorized official
• Heidi Rene Johnson, D.D.S.

  • Dentist
  • Mukilteo, WA
  • NPI 1902281496
  NPD (past)

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

{
    "created_epoch": "1774310400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1774310400000",
    "number": "1487592739",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15615 BEL RED RD STE D",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980082300",
            "telephone_number": "425-643-6072"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15615 BEL RED RD STE D",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980082300",
            "telephone_number": "425-643-6072"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVERGREEN FAMILY DENTISTRY BELLEVUE",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-03-24",
        "last_updated": "2026-03-24",
        "certification_date": "2026-03-24",
        "status": "A",
        "authorized_official_last_name": "PARK",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "OWNER DENTIST",
        "authorized_official_telephone_number": "425-643-6072",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Marian Elaine Evans, MA,LMHC
• Melissa Tarbuck Evans, DPT
• Naomi Evans
• Everett Physical Therapy & Sportsperformance Center PLLC (Bellevue Sports Physical Therapy)
• Evergreen Court
• Evergreen Park Afh
• Evergreen Washington Healthcare Greenwood, L.L.C. (Bellevue Post Acute)
• Lisa Eversole, OTRL
• Everything Spine Inc.
• Evidence Based Therapy Solutions

• Dentist in Bellevue, WA
• Providers in Bellevue, WA by specialty
• Dentist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2026; 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.