Timothy C Park, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DDS105080 Issued in CA

Practice address

1842 W Lincoln Ave Ste D
Anaheim, CA 92801-5489

Phone

(714) 956-8221

NPI assigned

Feb 4, 2020

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Cypress Dental Clinic

  • Dental Clinic/Center
  • Los Angeles, CA
  • NPI 1861916900
  NPD
• Kwang S. Kim DDS, Inc

  • Dental Clinic/Center
  • Los Angeles, CA
  • NPI 1427670603
  NPD

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

{
    "created_epoch": "1580774400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610582400000",
    "number": "1942832308",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1027 LOMA VISTA PL",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928332080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1842 W LINCOLN AVE STE D",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928015489",
            "telephone_number": "714-956-8221"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "906 N Vermont Ave",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900293519",
            "country_code": "US",
            "telephone_number": "323-522-3382",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2135 Cypress Ave",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900651212",
            "country_code": "US",
            "telephone_number": "323-223-0731",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "12124 Garfield Ave",
            "address_purpose": "LOCATION",
            "city": "South Gate",
            "state": "CA",
            "postal_code": "902808033",
            "country_code": "US",
            "telephone_number": "323-775-9070",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PARK",
        "first_name": "TIMOTHY",
        "middle_name": "C",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-02-04",
        "last_updated": "2021-01-14",
        "certification_date": "2021-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "DDS105080",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sung-Un Justin Park, MD
• Sungju Park
• Sungmin Park, L.AC.
• Tiffany Park, OD, MS
• Tiffany Park, MD
• Younghee Park, CCC-SLP
• Youngok Park, L.AC.
• Yunja Park
• Cindy C. Parker, DO
• David Parker, MD

• General Practice Dentistry in Anaheim, CA
• Providers in Anaheim, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2021; 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.