NPIMap

Organization Active NPI

D Park MPH Dental, Inc

  • General Practice Dentistry
  • Huntington Park, CA
National Provider Identifier
1922455914
Registry record updated Dec 4, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
D PARK MPH DENTAL, INC
Practice address
5802 Pacific Blvd
Huntington Park, CA 90255-2618
Phone
(310) 403-1117
NPI assigned
May 19, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2020

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

Authorized official

Name
David S Park, DDS
Title
Owner
Phone
(310) 403-1117

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X 53724 CA
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

5802 Pacific Blvd
Huntington Park, CA 90255-2618

Mailing address

5802 Pacific Blvd
Huntington Park, CA 90255-2618
Phone (310) 403-1117

Other identifiers 1

IdentifierTypeStateIssuer
53724MedicaidCA

Other names 1

  • HP Dental Group Doing business as

National Provider Directory

National Provider Directory
Tax ID family
D Park MPH Dental Inc3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Locations

5802 Pacific Blvd
Huntington Park, CA 90255
Phone (310) 403-1117

Ownership & related parties

Subparts reporting this organization as parent 2

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

NPI Registry JSON

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

{
    "created_epoch": "1463616000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1607040000000",
    "number": "1922455914",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5802 PACIFIC BLVD",
            "city": "HUNTINGTON PARK",
            "state": "CA",
            "postal_code": "902552618",
            "telephone_number": "310-403-1117"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5802 PACIFIC BLVD",
            "city": "HUNTINGTON PARK",
            "state": "CA",
            "postal_code": "902552618",
            "telephone_number": "310-403-1117"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "D PARK MPH DENTAL, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-05-19",
        "last_updated": "2020-12-04",
        "certification_date": "2020-12-04",
        "status": "A",
        "authorized_official_last_name": "PARK",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "310-403-1117",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "CA",
            "license": "53724",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "53724",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "HP Dental Group",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "HP Dental Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Huntington Park, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2020; 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.