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

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

50087 Issued in CA

Legal business name

CHARLES C. PARK D.D.S. A PROFESSIONAL CORPORATION

Practice address

1518 E. Lincoln Ave.
Orange, CA 92865

Phone

(714) 998-8998

Fax

(714) 998-0771

NPI assigned

Sep 2, 2015

Organization subpart

No

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

Authorized official

Name

Charles C. Park, D.D.S.NPI 1891865499

Title

President

Phone

(714) 998-8998

Specialties & licenses 1

Addresses

Other names 1

• Dream Dental Group Doing business as

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Charles C Park, D.D.S.

  • Dentist
  • Santa Ana, CA
  • NPI 1891865499
  Medicare reassignment Authorized official
• Hyun-Jung Kim, D.D.S.

  • General Practice Dentistry
  • Orange, CA
  • NPI 1538464771
  NPD (past)
• Jai Sin Park

  • Dentist
  • Santa Ana, CA
  • NPI 1285035337
  NPD (past)

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

{
    "created_epoch": "1441152000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1441152000000",
    "number": "1962879387",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1518 E. LINCOLN AVE.",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "92865",
            "telephone_number": "714-998-8998",
            "fax_number": "714-998-0771"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1518 E. LINCOLN AVE.",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "92865",
            "telephone_number": "714-998-8998",
            "fax_number": "714-998-0771"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHARLES C. PARK D.D.S. A PROFESSIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-09-02",
        "last_updated": "2015-09-02",
        "status": "A",
        "authorized_official_last_name": "PARK",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "C.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "714-998-8998",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "50087",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dream Dental Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Aida Chloe Charco
• Neel Chari, M.D.
• Ahmad Charifa
• Charitable Ventures of Orange County
• Davin Wilson Chark, M.D.
• Charles T Levitan MD Inc
• Kim James Charney, M.D.
• Leah Malilay Chase, MD
• Danielle Chater Lea
• Alexander Chau, PHARM.D.

• General Practice Dentistry in Orange, CA
• Providers in Orange, 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 Sep 2, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.