Cassie Park, DMD

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

22DI02843000 Issued in NJ

Practice address

3900 Park Ave Ste 105
Edison, NJ 08820-3063

Phone

(732) 452-0100

NPI assigned

May 21, 2021

Sex

Female

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.

• Rainbow Kids Dental, Inc.

  • Pediatric Dentistry
  • Edison, NJ
  • NPI 1497563555
  NPD

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

{
    "created_epoch": "1621555200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707782400000",
    "number": "1972178036",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3900 PARK AVE STE 105",
            "city": "EDISON",
            "state": "NJ",
            "postal_code": "088203063",
            "telephone_number": "732-452-0100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3900 PARK AVE STE 105",
            "city": "EDISON",
            "state": "NJ",
            "postal_code": "088203063",
            "telephone_number": "732-452-0100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "CASSIE",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-05-21",
        "last_updated": "2024-02-13",
        "certification_date": "2024-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "NJ",
            "license": "22DI02843000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Puja Parikh, DO
• Sagar Shailesh Parikh, M.D.
• Alyssa Parise
• Lindsay Parizman, PHARMD
• Park Avenue Surgery Center, LLC
• Esther Aeduk Park, FNP
• John C Park, MD
• Robert I Park, MD
• Solmi Park, RPH
• Soo Hyun Park

• Pediatric Dentistry in Edison, NJ
• Providers in Edison, NJ by specialty
• Pediatric Dentistry in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2024; 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.