Phillip S.H. Park DDS.,Inc.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

42593 Issued in CA

Legal business name

PHILLIP S.H. PARK DDS.,INC.

Practice address

742 E. Colorado Blvd.
Pasadena, CA 91101-2105

Phone

(626) 405-0707

Fax

(626) 795-2731

NPI assigned

Jul 26, 2006

Organization subpart

No

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

Authorized official

Name

Phillip S.H. Park, DDSNPI 1811917636

Title

President

Phone

(626) 405-0707

Specialties & licenses 1

Addresses

Other names 1

• Smart Dental Care Doing business as

Locations

Practitioners 2

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

• Phillip S.H Park, DDS

  • General Practice Dentistry
  • Pasadena, CA
  • NPI 1811917636
  NPD (past) Authorized official
• Julia H.P Lee, DDS

  • General Practice Dentistry
  • Pasadena, CA
  • NPI 1942224118
  NPD (past)

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

{
    "created_epoch": "1153872000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1439856000000",
    "number": "1750304192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "742 E. COLORADO BLVD.",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911012105",
            "telephone_number": "626-405-0707",
            "fax_number": "626-795-2731"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "742 E. COLORADO BLVD.",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911012105",
            "telephone_number": "626-405-0707",
            "fax_number": "626-795-2731"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHILLIP S.H. PARK DDS.,INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-26",
        "last_updated": "2015-08-18",
        "status": "A",
        "authorized_official_last_name": "PARK",
        "authorized_official_first_name": "PHILLIP",
        "authorized_official_middle_name": "S.H.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "626-405-0707",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "42593",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Smart Dental Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Emily Kristen Phelps
• Emily Phifer
• Kristen Phifer, OD
• Rajiv Philip, MD
• Jenna Philippe
• Sophia A Phillip, FNP
• Katherine Elizabeth Phillips-Rector, LMFT
• Allison Ruth Phillips, D.C.
• Atiya Lashae Phillips, LVN
• Earnest Ray Phillips Jr., B.A.

• General Practice Dentistry in Pasadena, CA
• Providers in Pasadena, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2015; 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.