David J Park, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

58303 Issued in CA

Practice address

2419 Ocean Ave
Suite a
San Francisco, CA 94127

Phone

(415) 333-4232

Fax

(415) 333-4237

NPI assigned

Nov 10, 2008

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• DJ Park DMD Inc

  • General Practice Dentistry
  • San Francisco, CA
  • NPI 1386460483
  NPD (past) Authorized official
• MM Park Dental Inc

  • General Practice Dentistry
  • Daly City, CA
  • NPI 1154282382
  NPD

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

{
    "created_epoch": "1226275200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1370390400000",
    "number": "1508010083",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2419 OCEAN AVE",
            "address_2": "SUITE A",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941272606",
            "telephone_number": "415-333-4232",
            "fax_number": "415-333-4237"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2419 OCEAN AVE",
            "address_2": "SUITE A",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "94127",
            "telephone_number": "415-333-4232",
            "fax_number": "415-333-4237"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "DAVID",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-11-10",
        "last_updated": "2013-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NV",
            "license": "LL-187-08",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "58303",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anna Laura Park
• Arick Charles Park, MD
• Catherine C. Park, M.D.
• Darci Rae Park, DPM
• David Park, M.D., PH.D.
• Deborah Park, MD
• Elbert Park
• Ellen Chang Park, NP
• Ellenne J Park, PT, DPT, CSRS
• Eun Sun Park, NP

• Dentist in San Francisco, CA
• Providers in San Francisco, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2013; 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.