Park Dental Group Inc

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

PARK DENTAL GROUP INC

Doing business as

LF Dental

Practice address

22611 Lake Forest Dr
Lake Forest, CA 92630-1700

Phone

(909) 543-5075

Fax

(907) 334-1030

NPI assigned

Oct 17, 2018

Last updated

Feb 14, 2019By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Tae Hoon Park, DDSNPI 1720271752

Title

Ceo

Phone

(909) 543-5075

Specialties & licenses 1

Addresses

Other names 1

• LF Dental Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Tae-Hoon Park, D.D.S.

  • General Practice Dentistry
  • Lewisburg, TN
  • NPI 1720271752
  NPD Authorized official

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

{
    "created_epoch": "1539734400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1550102400000",
    "number": "1952877854",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22611 LAKE FOREST DR",
            "city": "LAKE FOREST",
            "state": "CA",
            "postal_code": "926301700",
            "telephone_number": "909-543-5075",
            "fax_number": "907-334-1030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22611 LAKE FOREST DR",
            "city": "LAKE FOREST",
            "state": "CA",
            "postal_code": "926301700",
            "telephone_number": "909-543-5075",
            "fax_number": "907-334-1030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PARK DENTAL GROUP INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-10-17",
        "last_updated": "2019-02-14",
        "status": "A",
        "authorized_official_last_name": "PARK",
        "authorized_official_first_name": "TAE HOON",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "909-543-5075",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "LF Dental",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "LF Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Adil Panton
• Julie Ellen Papadakis, OTR/L, CST, CTI
• Parakleton Business Consulting LLC (Angel Medical Transportation)
• Rhea Parchejo
• Naomi Paris
• Chris Park
• Christy Park
• Hye Won Park
• Kwan Woo Park, L.AC.
• Paula Ann Park, FNP, MSN, BSN, RN

• Dental Clinic/Center in Lake Forest, CA
• Providers in Lake Forest, CA by specialty
• Dental Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2019; 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.