TRACEY PARK (NPI# 1104306729) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104306729 |
| Entity Type | Individual |
| Full Name | TRACEY PARK |
| Credential | DDS |
| Practice Address |
510 Washington Ave N Kent WA 98032-4453 |
| Mailing Address |
6950 Ne Campus Way Hillsboro OR 97124-5611 |
| Practice Telephone | 8554336825 |
| Mailing Telephone | 8554336825 |
| Enumeration Date | 2018-08-14 |
| Last Update Date | 2019-04-29 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 122300000X | Dentist | DE60879733 | WA | Dental Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 181 S 333rd St Ste 100, Federal Way, WA 98003 | 8554336825 |
| Street Address |
510 WASHINGTON AVE N |
| City | KENT |
| State | WA |
| Zip Code | 98032-4453 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396901559 | Jing Shen | Dentist | 510 Washington Ave N, Kent, WA 98032-4453 | 2008-08-06 |
| 1750948790 | Brian Le Ta | Dentist | 510 Washington Ave N, Kent, WA 98032-4453 | 2019-05-24 |
| 1639690167 | Yuanting Lu | Dentist | 510 Washington Ave N, Kent, WA 98032-4453 | 2017-07-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952866790 | Cornerstone Ocd Anxiety | Counselor | 415 Railroad Ave S, Kent, WA 98032 | 2019-02-06 |
| 1861962458 | Mohamed Osman Awad | Counselor | 124 4th Ave S Suite 230, Kent, WA 98032 | 2018-11-27 |
| 1649747387 | Hannah Grace Rosborough | Counselor | 19435 68th Ave S Bldg S Ste 109, Kent, WA 98032 | 2018-10-31 |
| 1063948164 | Teasya Kusumo | Marriage & Family Therapist | 232 2nd Avenue S., Suite 201, Kent, WA 98032 | 2017-05-10 |
| 1902331648 | Heather Kunce | Marriage & Family Therapist | 232 Second Ave S, Ste 201, Kent, WA 98032 | 2017-05-01 |
| 1043761489 | Julia Kocian | Social Worker | 1601 W Meeker St., #201, Sea Mar Kent Behavioral Health, Kent, WA 98032 | 2016-10-20 |
| 1760938518 | Phoeun Sath | Community Health Worker | 24328 Pacific Hwy, Kent, WA 98032 | 2016-08-31 |
| 1891241568 | Live Well Alliance, LLC | Counselor | 1103 W. Meeker Street #102, Kent, WA 98032 | 2016-08-31 |
| 1760938070 | Seattle Cpap | Durable Medical Equipment & Medical Supplies | 25329 74th Ave S, Kent, WA 98032 | 2016-08-28 |
| 1750736401 | William Dale | Technician, Other | 6302 S 238th Pl, Apt U205, Kent, WA 98032 | 2016-05-02 |
| Find all providers in zip 98032 | ||||
| Taxonomy Code | 122300000X |
| Grouping | Dental Providers |
| Classification | Dentist |
| A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336792118 | Gurpreet Kaur Shahi | Dentist | 9812 S 220th Pl, Kent, WA 98031-8112 | 2019-07-19 |
| 1053970210 | Mark Studeny Dds Pllc | Dentist | 18230 E Valley Hwy Ste 168, Kent, WA 98032-1231 | 2019-06-11 |
| 1174000467 | Jessica Elizabeth Wieker | Dentist | 940 Central Ave N Ste B, Kent, WA 98032-2052 | 2018-07-19 |
| 1548634231 | Rena Jhuty | Dentist | 11911 Se 245th Pl, Kent, WA 98030-9204 | 2015-11-18 |
| 1972986107 | Sue Kim | Dentist | 24128 130th Ave Se, Kent, WA 98030-9209 | 2015-07-07 |
| 1164804175 | Cuong Duy Nguyen | Dentist | 10032 Se 220th St, Kent, WA 98031-2510 | 2015-06-25 |
| 1083019210 | West Kent Dental LLC | Dentist | 23241 Pacific Hwy S, Kent, WA 98032-2721 | 2014-10-30 |
| 1093110215 | Lake Meridian Dental LLC | Dentist | 12906 Se Kent Kangley Rd, Kent, WA 98030-7940 | 2014-10-30 |
| 1487062816 | Tony Le | Dentist | 25248 Pacific Hwy S Ste 105, Kent, WA 98032-6530 | 2014-07-29 |
| 1982947107 | Kristin Lee Donaldson | Dentist | 1951 State Route 59 Ste B, Kent, OH 44240-8128 | 2013-04-05 |
| Find all providers in KENT | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.