NPIMap

Organization Active NPI

David Park DDS Inc

  • Dentist
  • Rancho Cordova, CA
National Provider Identifier
1629230610
Registry record updated Jun 30, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
53077 Issued in CA
Legal business name
DAVID PARK DDS INC
Practice address
10390 Coloma Rd Ste a
Rancho Cordova, CA 95670-2152
Phone
(916) 368-0440
Fax
(916) 368-1111
NPI assigned
Jun 30, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2008

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

Authorized official

Name
Dr. David S Park, DDS
Title
Owner President
Phone
(916) 368-0440

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X 53077 CA Primary

Addresses

Primary practice location

10390 Coloma Rd Ste a
Rancho Cordova, CA 95670-2152

Mailing address

10390 Coloma Rd Ste a
Rancho Cordova, CA 95670-2152
Phone (916) 368-0440

National Provider Directory

National Provider Directory
Tax ID family
David Park DDS Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1214784000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1214784000000",
    "number": "1629230610",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10390 COLOMA RD STE A",
            "city": "RANCHO CORDOVA",
            "state": "CA",
            "postal_code": "956702152",
            "telephone_number": "916-368-0440",
            "fax_number": "916-368-1111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10390 COLOMA RD STE A",
            "city": "RANCHO CORDOVA",
            "state": "CA",
            "postal_code": "956702152",
            "telephone_number": "916-368-0440",
            "fax_number": "916-368-1111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAVID PARK DDS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-30",
        "last_updated": "2008-06-30",
        "status": "A",
        "authorized_official_last_name": "PARK",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "OWNER  PRESIDENT",
        "authorized_official_telephone_number": "916-368-0440",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "CA",
            "license": "53077",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rancho Cordova, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2008; 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.