Dr. D. Park DDS, Inc.

Primary specialty

DentistTaxonomy code 122300000X

License

53724 Issued in CA

Legal business name

DR. D. PARK DDS, INC.

Practice address

1279 E Vista Way
Vista, CA 92084-4039

Phone

(760) 208-2518

Fax

(760) 340-3464

NPI assigned

Aug 30, 2018

Organization subpart

No

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

Authorized official

Name

David Park, DDS

Title

Owner

Phone

(310) 431-1117

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Smile Dental of Vista Doing business as

Locations

Practitioners 2

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

• Viet Le, DDS

  • Dentist
  • San Diego, CA
  • NPI 1831638329
  NPD (past)
• Vivian R Sales, DMD

  • General Practice Dentistry
  • Vista, CA
  • NPI 1891945978
  NPD (past)

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

{
    "created_epoch": "1535587200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1535587200000",
    "number": "1659853364",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1279 E VISTA WAY",
            "city": "VISTA",
            "state": "CA",
            "postal_code": "920844039",
            "telephone_number": "760-208-2518",
            "fax_number": "760-340-3464"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1279 E VISTA WAY",
            "city": "VISTA",
            "state": "CA",
            "postal_code": "920844039",
            "telephone_number": "760-208-2518",
            "fax_number": "760-340-3464"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR. D. PARK DDS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-08-30",
        "last_updated": "2018-08-30",
        "status": "A",
        "authorized_official_last_name": "PARK",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "310-431-1117",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "CA",
            "license": "53724",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "53724",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Smile Dental of Vista",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Smile Dental of Vista",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Doug Hope, DDS, Prof. Dental Corp.
• Christine Dougherty, LCSW
• Edward George Dougherty, COTA
• Matthew Doull, DPT
• Chris Colleen Downs
• Jose A Drago, DDS
• Ruth I Drago, DDS
• Lynne Eldon Drake, PHARM.D.
• Destiny Suzanne Drehs, RAD-T
• Kathleen Marie Drennan, BSN, MSN, APRN-C

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2018; 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.