NPIMap

Organization Active NPI

Milltown Dental LLC

  • Dentist
  • Wilmington, DE
National Provider Identifier
1659745941
Registry record updated Nov 24, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
G1-0001310 Issued in DE
Legal business name
MILLTOWN DENTAL LLC
Practice address
2601 Annand Dr
#18
Wilmington, DE 19808-3719
Phone
(302) 998-9594
Fax
(302) 998-8207
NPI assigned
Nov 24, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 24, 2015

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

Authorized official

Name
Dr. Jinwoo Park, D.D.S.NPI 1831354091
Title
Dentist/Owner
Phone
(302) 998-9594

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X G1-0001310 DE Primary

Addresses

Primary practice location

2601 Annand Dr
#18
Wilmington, DE 19808-3719

Mailing address

2601 Annand Dr
#18
Wilmington, DE 19808-3719
Phone (302) 998-9594

National Provider Directory

National Provider Directory

Locations

2601 Annand Dr
Ste 18
Wilmington, DE 19808
Phone (302) 998-9594

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1448323200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1448323200000",
    "number": "1659745941",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2601 ANNAND DR",
            "address_2": "#18",
            "city": "WILMINGTON",
            "state": "DE",
            "postal_code": "198083719",
            "telephone_number": "302-998-9594",
            "fax_number": "302-998-8207"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2601 ANNAND DR",
            "address_2": "#18",
            "city": "WILMINGTON",
            "state": "DE",
            "postal_code": "198083719",
            "telephone_number": "302-998-9594",
            "fax_number": "302-998-8207"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MILLTOWN DENTAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-11-24",
        "last_updated": "2015-11-24",
        "status": "A",
        "authorized_official_last_name": "PARK",
        "authorized_official_first_name": "JINWOO",
        "authorized_official_title_or_position": "DENTIST/OWNER",
        "authorized_official_telephone_number": "302-998-9594",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "DE",
            "license": "G1-0001310",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilmington, DE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 24, 2015; 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.