Charles C Park, D.D.S.

Primary specialty

DentistTaxonomy code 122300000X

License

50087 Issued in CA

Practice address

1702 S Main St
Santa Ana, CA 92707-1836

Phone

(714) 972-2828

Fax

(714) 972-2829

NPI assigned

Nov 9, 2006

Sex

Male

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 CA

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

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.

• Charles C. Park D.D.S. a Professional Corporation

  • General Practice Dentistry
  • Orange, CA
  • NPI 1962879387
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1163030400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1778198400000",
    "number": "1891865499",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1702 S MAIN ST",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927071836",
            "telephone_number": "714-972-2828",
            "fax_number": "714-972-2829"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1702 S MAIN ST",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927071836",
            "telephone_number": "714-972-2828",
            "fax_number": "714-972-2829"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "CHARLES",
        "middle_name": "C",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-09",
        "last_updated": "2026-05-08",
        "certification_date": "2026-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "50087",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sheila Paris, OTA
• Kim Pariseau, PSY. D.
• Brittney Joy Parish, MA
• Andrew Park
• Bojun Park, D.D.S.
• Frances Park
• Gil Ja Park
• Grace Woodrow Park, NP
• Hannah Park
• Helen Park, O.D.

• Dentist in Santa Ana, CA
• Providers in Santa Ana, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2026; 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.