Park and Scornavaca

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

Legal business name

PARK AND SCORNAVACA

Practice address

9727 Greenside Dr Ste 102
Cockeysville, MD 21030-5000

Phone

(410) 667-6404

NPI assigned

Mar 4, 2024

Organization subpart

No

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

Authorized official

Name

Mr. John T Moore

Title

General Manager

Phone

(302) 562-0060

Specialties & licenses 1

Addresses

Other names 1

• Keystone Orthodontics Doing business as

Locations

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

{
    "created_epoch": "1709510400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1709510400000",
    "number": "1891552196",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1250 PEOPLES PLZ",
            "city": "NEWARK",
            "state": "DE",
            "postal_code": "197025701",
            "telephone_number": "302-836-5072",
            "fax_number": "302-836-2690"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9727 GREENSIDE DR STE 102",
            "city": "COCKEYSVILLE",
            "state": "MD",
            "postal_code": "210305000",
            "telephone_number": "410-667-6404"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PARK AND SCORNAVACA",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-03-04",
        "last_updated": "2024-03-04",
        "certification_date": "2024-03-04",
        "status": "A",
        "authorized_official_last_name": "MOORE",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "GENERAL MANAGER",
        "authorized_official_telephone_number": "302-562-0060",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Keystone Orthodontics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Megumi Otake, OTR
• Vernon F. Ottenritter Jr., D.D.S.
• Nathaniel Toyin Owoade, PT FOR HAPPY DAVIC
• Paragon Health LLC
• Aniyah Parham
• Hyeshin Park, PHD, MSSA, LCSW-C
• Robert D Park, D.M.D.
• Christopher Parker, PT
• Courtney Pate, CRNP
• Dwayne R Pate Jr., LMSW

• Orthodontics and Dentofacial Orthopedics Dentistry in Cockeysville, MD
• Providers in Cockeysville, MD by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 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.