CMP Dental Group, P.C.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

28207 Issued in TX

Legal business name

CMP DENTAL GROUP, P.C.

Practice address

2639 Walnut Hill LN Ste 225
Dallas, TX 75229-5699

Phone

(972) 423-6804

NPI assigned

Jul 13, 2017

Organization subpart

No

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

Authorized official

Name

Charles C. Park, D.D.S.

Title

President

Phone

(972) 423-6804

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1499904000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1609398411",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2639 WALNUT HILL LN.",
            "address_2": "STE. 225",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752295640",
            "telephone_number": "972-423-6804"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2639 WALNUT HILL LN STE 225",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752295699",
            "telephone_number": "972-423-6804"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CMP DENTAL GROUP, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-07-13",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "PARK",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "C.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "972-423-6804",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "28207",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• General Practice Dentistry in Dallas, TX
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.