GH Park DDS a Dental Corporation

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

License

49631 Issued in CA

Legal business name

GH PARK DDS A DENTAL CORPORATION

Practice address

1031 Rosecrans Ave Ste 104
Fullerton, CA 92833-1946

Phone

(714) 530-1948

Fax

(714) 530-1186

NPI assigned

Jan 22, 2018

Organization subpart

No

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

Authorized official

Name

Gene Park, DDSNPI 1235304791

Title

President

Phone

(310) 780-1296

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.

• Gene Hyounglin Park, D.D.S., M.S.

  • Periodontics
  • Fullerton, CA
  • NPI 1235304791
  NPD Authorized official

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

{
    "created_epoch": "1516579200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1516579200000",
    "number": "1780192005",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1031 ROSECRANS AVE STE 104",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928331946",
            "telephone_number": "714-530-1948",
            "fax_number": "310-530-1186"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1031 ROSECRANS AVE STE 104",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928331946",
            "telephone_number": "714-530-1948",
            "fax_number": "714-530-1186"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GH PARK DDS A DENTAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-01-22",
        "last_updated": "2018-01-22",
        "status": "A",
        "authorized_official_last_name": "PARK",
        "authorized_official_first_name": "GENE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "310-780-1296",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "CA",
            "license": "49631",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Paula George
• Mari Franz Geronimo
• Michele Heather Gerrity, M.S.
• Jack Gershfeld, LMFT
• Dalton P Gerstle
• Parisa Ghahremani, AMFT
• Hovhannes Ghazaryan, MD
• Mary Samson Ghebrehiwet
• Mohammad Javad Gheiratmand
• Ehsan Ghetmiri, M.D.

• Dental Clinic/Center in Fullerton, CA
• Providers in Fullerton, CA by specialty
• Dental Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2018; 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.