Conrad Parks, D.D.S.

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

61078 Issued in KS

Practice address

4601 W 109TH St Ste 217
Overland Park, KS 66211-1314

Phone

(402) 469-4386

NPI assigned

Apr 7, 2014

Last updated

Apr 7, 2014By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Parks Children's Dentistry

  • Pediatric Dentistry
  • Overland Park, KS
  • NPI 1689084311
  NPD (past) Authorized official

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

{
    "created_epoch": "1396828800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1396828800000",
    "number": "1568880581",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4601 W 109TH ST STE 217",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662111314",
            "telephone_number": "402-469-4386"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4601 W 109TH ST STE 217",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662111314",
            "telephone_number": "402-469-4386"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARKS",
        "first_name": "CONRAD",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-04-07",
        "last_updated": "2014-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "KS",
            "license": "61078",
            "primary": true
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "NE",
            "license": "7058",
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "MO",
            "license": "2014009234",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kristine Nichole Parkhurst, NNP-BC
• Ethan Hunter Avery Parkinson
• Parks Children's Dentistry
• Alison Parks
• Amanda B Parks, MSN, ARNP
• Jaime L Parks, MS CCC-A, AU.D.
• Jennifer Ruck Parks
• Parkway Home Plus LLC
• Karen Lorraine Parmely, APRN
• Mary Parn

• Pediatric Dentistry in Overland Park, KS
• Providers in Overland Park, KS by specialty
• Pediatric Dentistry in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2014; 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.