Anna K Park

Primary specialty

EndodonticsTaxonomy code 1223E0200X

License

D1021270 Issued in NJ

Practice address

50 N Main St
Mullica Hill, NJ 08062-9409

Phone

(856) 478-9500

Fax

(856) 478-9547

NPI assigned

Jun 24, 2008

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1214265600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1547596800000",
    "number": "1871754630",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50 N MAIN ST",
            "city": "MULLICA HILL",
            "state": "NJ",
            "postal_code": "080629409",
            "telephone_number": "856-478-9500",
            "fax_number": "856-478-9547"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 N MAIN ST",
            "city": "MULLICA HILL",
            "state": "NJ",
            "postal_code": "080629409",
            "telephone_number": "856-478-9500",
            "fax_number": "856-478-9547"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "ANNA",
        "middle_name": "K",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-06-24",
        "last_updated": "2019-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "NJ",
            "license": "D1021270",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cody Ore, PHARMD
• Paul Russell Osterdahl Jr., D.O.
• William Ott, D.O.
• Brooke Owens, PHARMD
• Jeet Parekh, DO
• Ankita R Patel, DO
• Deep Patel
• Harsh Patel, DO
• Het Patel, DO
• Jasmine Patel, MD

• Endodontics in Mullica Hill, NJ
• Providers in Mullica Hill, NJ by specialty
• Endodontics in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.