Daniel Park, M.D.

Primary specialty

Plastic Surgery PhysicianTaxonomy code 208200000X

License

79642 Issued in GA

Practice address

2285 Asquith Ave SW Ste 200
Marietta, GA 30008

Phone

(770) 485-1554

NPI assigned

Dec 10, 2008

Sex

Male

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• Georgia Plastic & Reconstructive Surgery

  • Plastic Surgery Physician
  • Marietta, GA
  • NPI 1447580790
  Medicare reassignment NPD
• Oracle Anesthesia of Georgia LLC

  • Anesthesiology Physician
  • Hiram, GA
  • NPI 1629350566
  NPD (past)

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

{
    "created_epoch": "1228867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1527984000000",
    "number": "1952546533",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2285 ASQUITH AVE SW STE 200",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300086092",
            "telephone_number": "770-485-1554"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2285 ASQUITH AVE SW STE 200",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "30008",
            "telephone_number": "770-485-1554"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "DANIEL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-12-10",
        "last_updated": "2018-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "PA",
            "license": "MD440792",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "FL",
            "license": "ME122781",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "PA",
            "license": "MT193449",
            "primary": false
        },
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "GA",
            "license": "79642",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shrinath Parimi, MD
• Bailey Kendrick Paris, LMSW
• Raymond Alan Paris, D.C.
• Tali Pariser, DC
• Brandon M Paritz, MD
• Daniel J Park, DMD
• Ji Won Park, DMD
• Jong Bume Park, LAC
• Jong-Beak Park, R.PH., PH.D.
• Jungsub Park, D.C.

• Plastic Surgery Physician in Marietta, GA
• Providers in Marietta, GA by specialty
• Plastic Surgery Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2018; 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.