Chang Soon Park, D.M.D.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DS039272 Issued in PA

Practice address

110 Hopewell Rd Ste 1B
Downingtown, PA 19335-1047

Phone

(610) 269-8522

NPI assigned

Sep 14, 2011

Last updated

Nov 27, 2023By 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 3

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Park Family Dentistry PC

  • General Practice Dentistry
  • Downingtown, PA
  • NPI 1447039144
  NPD Authorized official
• Rapozafamily Dentistry

  • Dentist
  • Prospect Park, PA
  • NPI 1710142625
  NPD (past)

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

{
    "created_epoch": "1315958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701043200000",
    "number": "1740562883",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 HOPEWELL RD STE 1B",
            "city": "DOWNINGTOWN",
            "state": "PA",
            "postal_code": "193351047"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 HOPEWELL RD STE 1B",
            "city": "DOWNINGTOWN",
            "state": "PA",
            "postal_code": "193351047",
            "telephone_number": "610-269-8522"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "CHANG",
        "middle_name": "SOON",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-09-14",
        "last_updated": "2023-11-27",
        "certification_date": "2023-11-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "055756",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "60669",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "PA",
            "license": "DS039272",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sarah Padilla, MS, RD, LDN
• Michele Maria Paiva, C.HT
• Bridget Panza, M.S, LPC
• John B Pardini Jr., D.M.D.
• Park Family Dentistry PC
• Heather Pascale
• Patricia A Pasley-Glover
• Patch Mart LLC
• Dhruvi Patel
• Kreena Patel

• General Practice Dentistry in Downingtown, PA
• Providers in Downingtown, PA by specialty
• General Practice Dentistry in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2023; 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.