Joseph Park DDS Inc

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

Legal business name

JOSEPH PARK DDS INC

Doing business as

Sprout Pediatric Dentistry

Practice address

925 W Foothill Blvd Ste C
Monrovia, CA 91016-1930

Phone

(626) 408-0800

NPI assigned

Aug 29, 2022

Organization subpart

No

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

Authorized official

Name

Joseph ParkNPI 1053713156

Title

President

Phone

(626) 408-0800

Specialties & licenses 1

Addresses

Other names 1

• Sprout Pediatric Dentistry Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Joseph Park, DDS

  • Pediatric Dentistry
  • Monrovia, CA
  • NPI 1053713156
  NPD Authorized official

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

{
    "created_epoch": "1661731200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1661731200000",
    "number": "1740900125",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "925 W FOOTHILL BLVD STE C",
            "city": "MONROVIA",
            "state": "CA",
            "postal_code": "910161930",
            "telephone_number": "626-408-0800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "925 W FOOTHILL BLVD STE C",
            "city": "MONROVIA",
            "state": "CA",
            "postal_code": "910161930",
            "telephone_number": "626-408-0800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOSEPH PARK DDS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-08-29",
        "last_updated": "2022-08-29",
        "certification_date": "2022-08-29",
        "status": "A",
        "authorized_official_last_name": "PARK",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "626-408-0800"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sprout Pediatric Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Yahaira Jordan
• Zierah Jordan
• Linda Jorgensen
• Abbie Jorolemon
• Annalisa Jose
• Chayil Joseph
• Ericka Joseph
• Jordan Lee Joseph
• Michelle Joseph
• Tedsen Joseph

• Pediatric Dentistry in Monrovia, CA
• Providers in Monrovia, CA by specialty
• Pediatric Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 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.