Dr Park Dental Corporation

Primary specialty

DentistTaxonomy code 122300000X

License

53724 Issued in CA

Legal business name

DR PARK DENTAL CORPORATION

Doing business as

West AV Dental Group

Practice address

38745 Tierra Subida Ave Ste 150
Palmdale, CA 93551-4567

Phone

(661) 272-9091

NPI assigned

Aug 3, 2018

Last updated

Aug 3, 2018By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. David Park, DDSNPI 1942410501

Title

Ceo

Phone

(310) 403-1117

Specialties & licenses 1

Addresses

Other names 1

• West AV Dental Group Doing business as

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• David S Park, DDS, MPH

  • General Practice Dentistry
  • Rancho Cordova, CA
  • NPI 1942410501
  Authorized official Same address or phone

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

{
    "created_epoch": "1533254400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1533254400000",
    "number": "1790263465",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1669 W AVENUE J STE 305",
            "city": "LANCASTER",
            "state": "CA",
            "postal_code": "935342870",
            "telephone_number": "661-802-7544"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "38745 TIERRA SUBIDA AVE STE 150",
            "city": "PALMDALE",
            "state": "CA",
            "postal_code": "935514567",
            "telephone_number": "661-272-9091"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR PARK DENTAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-08-03",
        "last_updated": "2018-08-03",
        "status": "A",
        "authorized_official_last_name": "PARK",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "310-403-1117",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "53724",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "West AV Dental Group",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "West AV Dental Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Marian Dorsey-Williams
• Katie R Dostalek, OTR/L
• Eltonique-Natasha Michele Dotson
• William M Dowell II
• Dr Kamran Parsa Inc (NeuroSpine Institute)
• Dr Yara Lopez Dentistry Professional Corp
• Dr. Glenn Hiura
• Dr. Yury B. Geylikman, a Professional Dental Corporation
• Christine Marie Dreisen, CPNP
• Alyssa Dawn Du Boise

• Dentist in Palmdale, CA
• Providers in Palmdale, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 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.