Active NPI
Christine Park, DDS
- General Practice Dentistry
National Provider Identifier
1861698326
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 019027321
- Practice address
- Unit 15660
Apo, AP 96271-5660 - Phone
- (315) 737-9192
- NPI assigned
- Jun 22, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 019027321 | IL | Primary |
Addresses
Primary practice location
Unit 15660
Apo, AP 96271-5660
Mailing address
Unit 15660
Apo, AP 96271-5660
Phone (315) 737-9192
Other practice location 1
200 Milwaukee Ave
Buffalo Grove, IL 60089-2812
Phone (847) 520-0770
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 019027321 | IL | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Beyer Dental LTD | General Practice | Past | Accepting new patients |
| Nextgen Endodontics LTD | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Endodontics
- Buffalo Grove, IL
- NPI 1295013290
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1182470400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1556755200000",
"number": "1861698326",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "MIL",
"address_1": "UNIT 15660",
"city": "APO",
"state": "AP",
"postal_code": "962715660",
"telephone_number": "315-737-9192"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "MIL",
"address_1": "UNIT 15660",
"city": "APO",
"state": "AP",
"postal_code": "962715660",
"telephone_number": "315-737-9192"
}
],
"practiceLocations": [
{
"address_1": "200 Milwaukee Ave",
"address_purpose": "LOCATION",
"city": "Buffalo Grove",
"state": "IL",
"postal_code": "600892812",
"country_code": "US",
"telephone_number": "847-520-0770",
"fax_number": "847-520-1179",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "PARK",
"first_name": "CHRISTINE",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-06-22",
"last_updated": "2019-05-02",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "IL",
"license": "019027321",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.