Michelle Park

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

0401418988 Issued in VA

Practice address

11124 Midlothian Tpke
North Chesterfield, VA 23235-4712

Phone

(804) 893-5079

NPI assigned

Mar 5, 2024

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

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 and National Provider Directory roles.

• Kaitlin Parkman DDS PLLC

  • General Practice Dentistry
  • North Chesterfield, VA
  • NPI 1225898570
  NPD

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

{
    "created_epoch": "1709596800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717545600000",
    "number": "1831956861",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "701 N 1ST ST APT 204",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232191341",
            "telephone_number": "703-953-0428"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11124 MIDLOTHIAN TPKE",
            "city": "NORTH CHESTERFIELD",
            "state": "VA",
            "postal_code": "232354712",
            "telephone_number": "804-893-5079"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "MICHELLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-03-05",
        "last_updated": "2024-06-05",
        "certification_date": "2024-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "VA",
            "license": "0401418988",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cecilia Pannone
• Paraclete Counseling, PC
• Paradise Home Care, Inc.
• Elizabeth Parham, MAPC
• Chanhi Park, M.D.
• Deborah Yvonne Parker, MS; LPC
• Delvin L. Parker
• Julia Parker
• Makenzie Parrish
• Heather Pate

• General Practice Dentistry in North Chesterfield, VA
• Providers in North Chesterfield, VA by specialty
• General Practice Dentistry in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2024; 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.