Douglas D. Parks, D.D.S.

Primary specialty

DentistTaxonomy code 122300000X

License

DD1903 Issued in NM

Practice address

501 S Main Ave
Aztec, NM 87410-2247

Phone

(505) 334-6116

NPI assigned

Apr 16, 2009

Last updated

Apr 16, 2009By 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 1

Addresses

Other identifiers 1

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.

• Smilemaker Dental Inc.

  • General Practice Dentistry
  • Aztec, NM
  • NPI 1679507859
  NPD (past) Authorized official

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

{
    "created_epoch": "1239840000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1239840000000",
    "number": "1700029964",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 S MAIN AVE",
            "city": "AZTEC",
            "state": "NM",
            "postal_code": "874102247",
            "telephone_number": "505-334-6116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 S MAIN AVE",
            "city": "AZTEC",
            "state": "NM",
            "postal_code": "874102247",
            "telephone_number": "505-334-6116"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARKS",
        "first_name": "DOUGLAS",
        "middle_name": "D.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-04-16",
        "last_updated": "2009-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NM",
            "license": "DD1903",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DENTAL OFFICE",
            "identifier": "1679507859",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lucia Elizabeth Naranjo, RN, MSN
• Tanya M Ober, MS, CCC-SLP
• Josephine Snyder Olson, LPCC
• Lissa Ellen Paak, OT
• Susie Palmer
• Elvira Payton
• Katrina Perfect
• Physical Therapy & Sports Medicine of Northern New Mexico, Inc.
• Bryan Standley Poe, DO
• Kathleen A Price

• Dentist in Aztec, NM
• Providers in Aztec, NM by specialty
• Dentist in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2009; 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.