Park Dental, Inc.

Primary specialty

DentistTaxonomy code 122300000X

License

53724 Issued in CA

Legal business name

PARK DENTAL, INC.

Practice address

241 N Palm St
Turlock, CA 95380-4028

Phone

(209) 667-2254

Fax

(209) 667-2274

NPI assigned

Feb 25, 2015

Organization subpart

No

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

Authorized official

Name

David Park, DDS

Title

Director

Phone

(209) 667-2254

Specialties & licenses 3

Addresses

Other names 1

• Palm Dental Group Doing business as

Locations

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

{
    "created_epoch": "1424822400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1424908800000",
    "number": "1962894170",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "241 N PALM ST",
            "city": "TURLOCK",
            "state": "CA",
            "postal_code": "953804028",
            "telephone_number": "209-667-2254",
            "fax_number": "209-667-2274"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "241 N PALM ST",
            "city": "TURLOCK",
            "state": "CA",
            "postal_code": "953804028",
            "telephone_number": "209-667-2254",
            "fax_number": "209-667-2274"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PARK DENTAL, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-02-25",
        "last_updated": "2015-02-26",
        "status": "A",
        "authorized_official_last_name": "PARK",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "209-667-2254",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "CA",
            "license": "53724",
            "primary": true
        },
        {
            "code": "1223E0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Endodontics",
            "state": "CA",
            "license": "53191",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "CA",
            "license": "57684",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Palm Dental Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jazmine Palominos Gonzalez
• Kayla Ann Pancoast
• Jorge Pantoja, DDS
• Payal Chandra Pardiwala, FNP-C
• Danielle Parga
• Sunny Sunjoo Park, FNP
• Vernon Guy Park, M.D.
• Stephanie Elizabeth Parker, CRNA
• Faith Parra
• Alicia Partida

• Dentist in Turlock, CA
• Providers in Turlock, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2015; 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.