Gloria S. Park, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

063644 Issued in NY

Practice address

2 Executive Blvd Ste 304
Suffern, NY 10901-8219

Phone

(845) 357-4100

NPI assigned

Jun 8, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Affordable Dentures & Implants - Ny, P.C.

  • General Practice Dentistry
  • Suffern, NY
  • NPI 1285466151

  General Practice

  NPD
• Implant Reconstruction & General Dentistry of Rockland, PLLC

  • General Practice Dentistry
  • Suffern, NY
  • NPI 1689771990

  General Practice

  NPD
• Aaron M Parada DDS LTD

  • Dentist
  • Union City, NJ
  • NPI 1134586522
  NPD (past)
• Vivian Villalobos DDS PA

  • Dental Clinic/Center
  • Union City, NJ
  • NPI 1043919863
  NPD (past)

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

{
    "created_epoch": "1623110400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737504000000",
    "number": "1720655848",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "622 W 168TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100323720"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 EXECUTIVE BLVD STE 304",
            "city": "SUFFERN",
            "state": "NY",
            "postal_code": "109018219",
            "telephone_number": "845-357-4100"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "586 Morris Ave",
            "address_purpose": "LOCATION",
            "city": "Bronx",
            "state": "NY",
            "postal_code": "104515172",
            "country_code": "US",
            "telephone_number": "646-401-7878",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4801-07 Bergenline Ave",
            "address_purpose": "LOCATION",
            "city": "Union City",
            "state": "NJ",
            "postal_code": "07087",
            "country_code": "US",
            "telephone_number": "201-865-6740",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PARK",
        "first_name": "GLORIA",
        "middle_name": "S.",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-08",
        "last_updated": "2025-01-22",
        "certification_date": "2025-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NJ",
            "license": "22DI02868500",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "063644",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stephanie Marie Pappas, PA-C
• Richard Edward Para, RPH
• Fatima Paras, RN
• Leah Paretzky
• Shital Ramesh Parikh, MD
• Adam Justin Parker, MD
• Bredgette Marie Parker, RN
• Elisheva Parry, LCSW
• Partners in Pediatrics PLLC
• Joseph Richard Paskowski, MD

• General Practice Dentistry in Suffern, NY
• Providers in Suffern, NY by specialty
• General Practice Dentistry in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2025; 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.