DR. JILL PARK (NPI# 1124389606) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124389606 |
| Entity Type | Individual |
| Full Name | DR. JILL PARK |
| Practice Address |
45 Mariano Bishop Blvd Fall River MA 02721-2346 |
| Mailing Address |
400 Technology Center Dr Apt #4209 Stoughton MA 02072-4714 |
| Practice Telephone | 7815809081 |
| Mailing Telephone | 7815809081 |
| Enumeration Date | 2012-05-31 |
| Last Update Date | 2012-05-31 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
DN1855958 | MA | Dental Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144665381 | Jill Owenby Park | Specialist/Technologist | 377 School Rd, White Bluff, TN 37187-9023 | 2013-05-01 |
| Street Address |
45 MARIANO BISHOP BLVD |
| City | FALL RIVER |
| State | MA |
| Zip Code | 02721-2346 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881130755 | Mitali Hariawala | Dentist | 45 Mariano Bishop Blvd, Fall River, MA 02721-2346 | 2017-01-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174139703 | Ervin Pejo | Dentist | 824 William S Canning Blvd A, Fall River, MA 02721 | 2020-09-18 |
| 1316561814 | Sravanthi Tapal | Dentist | 45 Mariano South, Mariano Bishop Blvd, Fallriver, MA 02721 | 2020-06-01 |
| 1447808811 | Guilbert Maria | Dentist | 45 Mariano South, Mariano Bishop Blvd, Fall River, MA 02721 | 2019-08-29 |
| 1619466638 | Alpha Dental Center, P.c | Dentist | 516 Newton St., Fall River, MA 02721 | 2018-05-04 |
| 1083987374 | Fall River Dental Center | Dentist | 516 Newton St, Fall River, MA 02721 | 2012-02-16 |
| 1033489109 | Phoenix Psychiatric Services | Clinic/Center | 101 Jeremiah Sullivan Dr, Fall River, MA 02721 | 2012-01-06 |
| 1619271491 | Amanda Leigh Sims | Student in an Organized Health Care Education/Training Program | 1575 North Main Street, Fall River, MA 02721 | 2011-01-07 |
| 1346481280 | Paul Ongulo | Counselor | 170 Pleasant Street, Fall River, MA 02721 | 2009-03-23 |
| 1508020439 | Dental Dreams LLC | Dentist | 45 Mariano South Bishop Blvd, Fall River, MA 02721 | 2008-07-10 |
| 1174793244 | Joan P Riley | Social Worker | 700 Shore Dr Unit 605, Fall River, MA 02721 | 2008-03-05 |
| Find all providers in zip 02721 | ||||
| Taxonomy Code | 1223G0001X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | General Practice |
| A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. |
| Notes: Source: Academy of General Dentistry |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174139703 | Ervin Pejo | Dentist | 824 William S Canning Blvd A, Fall River, MA 02721 | 2020-09-18 |
| 1083125397 | Ahmed Hashim Awad | Dentist | 933 Pleasant St Ste 102, Fall River, MA 02723-1000 | 2017-10-13 |
| 1083987374 | Fall River Dental Center | Dentist | 516 Newton St, Fall River, MA 02721 | 2012-02-16 |
| 1366743619 | Ju-yong Chung | Dentist | 45 Mariano S Bishop Blvd, Fall River, MA 02721-2346 | 2010-11-03 |
| 1225348428 | Dentzz Dental Limited Partnership | Dentist | 427 Plymouth Avenue, Fall River, MA 02721-4231 | 2010-10-21 |
| 1508020439 | Dental Dreams LLC | Dentist | 45 Mariano South Bishop Blvd, Fall River, MA 02721 | 2008-07-10 |
| 1073721114 | Alpha Dental Center of Fall River, LLC | Dentist | 230 Rhode Island Ave, Fall River, MA 02724-3525 | 2007-05-21 |
| 1093859456 | Richard Dana Lajoie | Dentist | 450 High St, Fall River, MA 02720-3345 | 2007-02-19 |
| 1700922655 | Carl J Ferreira | Dentist | 1190 Stafford Rd, Fall River, MA 02721-3228 | 2007-01-29 |
| 1700989282 | J Gagliarde P Ponte Dds | Dentist | 1120 North Main Street, Fall River, MA 02720 | 2006-09-07 |
| Find all providers in FALL RIVER | ||||
| City | FALL RIVER |
| Zip Code | 02721 |
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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.