David Park MPH DDS Professional Corporation

Primary specialty

DentistTaxonomy code 122300000X

Legal business name

DAVID PARK MPH DDS PROFESSIONAL CORPORATION

Practice address

1669 W Avenue J
305
Lancaster, CA 93534-2866

Phone

(661) 802-7544

NPI assigned

Mar 9, 2017

Organization subpart

No

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

Authorized official

Name

David S Park, DDS

Title

Owner

Phone

(661) 802-7455

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1489017600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1489017600000",
    "number": "1548701626",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1669 W AVENUE J",
            "address_2": "305",
            "city": "LANCASTER",
            "state": "CA",
            "postal_code": "935342866",
            "telephone_number": "661-802-7544"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1669 W AVENUE J",
            "address_2": "305",
            "city": "LANCASTER",
            "state": "CA",
            "postal_code": "935342866",
            "telephone_number": "661-802-7544"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAVID PARK MPH DDS PROFESSIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-03-09",
        "last_updated": "2017-03-09",
        "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": "661-802-7455",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "53724",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Joyce R Daniels
• Ramy Danon, M.S. MFT
• Alex Kingsley Danso, MD
• Nia Imani Darbeau
• Birendra Nath Das, M.D.
• Jamie David, M.A.
• Tara Luela Vincent Davidson, LMFT
• Diana Davio, M.D.
• Alyssa A Davis, MA, LMFT
• Aracely J Davis

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2017; 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.