NPIMap

Organization Active NPI

Clinton H. Park, D.D.S., Inc

  • Dentist
  • Encinitas, CA
National Provider Identifier
1710340294
Registry record updated Apr 1, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
CLINTON H. PARK, D.D.S., INC
Practice address
415 Santa Fe Dr
Encinitas, CA 92024-5134
Phone
(760) 388-2161
Fax
(760) 904-4035
NPI assigned
Apr 1, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2016

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

Authorized official

Name
Dr. Clinton H Park, DDS
Title
Owner
Phone
(760) 388-2161

Specialties & licenses 1

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

Addresses

Primary practice location

415 Santa Fe Dr
Encinitas, CA 92024-5134

Mailing address

17000 Red Hill Avenue
Irvine, CA 92614
Phone (714) 845-8890

Other names 1

  • Encinitas Smiles Dentistry Dental Group Doing business as

National Provider Directory

National Provider Directory

Locations

415 Santa Fe Dr
Encinitas, CA 92024
Phone (760) 388-2161

Practitioners & affiliated clinicians

Practitioners 5

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": "1459468800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1459468800000",
    "number": "1710340294",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17000 RED HILL AVENUE",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "92614",
            "telephone_number": "714-845-8890",
            "fax_number": "949-474-1495"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "415 SANTA FE DR",
            "city": "ENCINITAS",
            "state": "CA",
            "postal_code": "920245134",
            "telephone_number": "760-388-2161",
            "fax_number": "760-904-4035"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLINTON H. PARK, D.D.S., INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-04-01",
        "last_updated": "2016-04-01",
        "status": "A",
        "authorized_official_last_name": "PARK",
        "authorized_official_first_name": "CLINTON",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "760-388-2161",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Encinitas Smiles Dentistry Dental Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Encinitas, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2016; 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.