Smile Park Dental LLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

SMILE PARK DENTAL LLC

Practice address

1702 Transportation Blvd Ste F
Crofton, MD 21114-2151

Phone

(410) 721-5000

NPI assigned

Apr 19, 2022

Last updated

Apr 19, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Michael Y Park, DMDNPI 1457906257

Title

Dr

Phone

(410) 721-5000

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Michael Y Park, DMD

  • General Practice Dentistry
  • Crofton, MD
  • NPI 1457906257
  NPD Authorized official

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

{
    "created_epoch": "1650326400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1650326400000",
    "number": "1710620414",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1702 TRANSPORTATION BLVD STE F",
            "city": "CROFTON",
            "state": "MD",
            "postal_code": "211142151",
            "telephone_number": "410-721-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1702 TRANSPORTATION BLVD STE F",
            "city": "CROFTON",
            "state": "MD",
            "postal_code": "211142151",
            "telephone_number": "410-721-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SMILE PARK DENTAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-04-19",
        "last_updated": "2022-04-19",
        "certification_date": "2022-04-19",
        "status": "A",
        "authorized_official_last_name": "PARK",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "Y",
        "authorized_official_title_or_position": "DR",
        "authorized_official_telephone_number": "410-721-5000",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bailie Siddiqui, IBCLC
• Sightrite Medical MD LLC
• Linda Hall Siomporas, MED, LCPC
• Stacey Jean Slack
• Marsenia Smalls
• Amari Smith, BEHAVIOR TECHNICIAN
• Austin Michael Smith
• Emmanuel Smith
• Steven Douglas Smith, L.AC
• Timothy James Smith, PT

• Dental Clinic/Center in Crofton, MD
• Providers in Crofton, MD by specialty
• Dental Clinic/Center in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2022; 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.