D PARK MPH DDS DENTAL CORPORATION (NPI# 1124572284) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124572284 |
| Entity Type | Organization |
| Organization Name | D PARK MPH DDS DENTAL CORPORATION |
| Other Organization Name | PACIFIC DENTAL GROUP |
| Practice Address |
7743 West Ln Ste C5 Stockton CA 95210-3381 |
| Practice Telephone | 2094741101 |
| Mailing Telephone | 2094741101 |
| Enumeration Date | 2016-08-06 |
| Last Update Date | 2016-08-12 |
| Authorized Official Name | DR. DAVID S PARK (PRESIDENT/DENTIST) |
| Authorized Official Telephone | 9163656263 |
| Authorized Official Credential | DDS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
53724 | CA | Dental Providers |
| Other Name | Type Code |
|---|---|
| Pacific Dental Group | Doing Business As Name - Organization |
| Street Address |
7743 WEST LN STE C5 |
| City | STOCKTON |
| State | CA |
| Zip Code | 95210-3381 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932114766 | Laurent Vien | Dentist | 7743 West Ln Ste C5, Stockton, CA 95210-3381 | 2006-07-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063021970 | Leslie Jazmin Marin | Student in an Organized Health Care Education/Training Program | 7109 Danny Dr, Stockton, Stockton, CA 95210 | 2020-07-27 |
| 1043866692 | Alexis Thomasson | Behavior Technician | 7109 Danny Drive, Stockton, CA 95210 | 2019-08-09 |
| 1821651324 | Maria Guadalupe Toledo | Lactation Consultant, Non-RN | 7912 Hammer Lane, Stockton, CA 95210 | 2019-04-19 |
| 1508226440 | Active Life Adult Day Care, Inc. | Clinic/Center | 7209 Tam O'shanter Dr., Stockton, CA 95210 | 2016-03-04 |
| 1548631260 | Rachel Standley | Substance Abuse Rehabilitation Facility | 8017 El Cajon St, Stockton, CA 95210 | 2015-10-08 |
| 1225435308 | Active Life Medical Produtcs Inc | Durable Medical Equipment & Medical Supplies | 611 W Grider Way, Stockton, CA 95210 | 2014-12-04 |
| 1942633318 | Kimberly Ruiz Dizon | Physician Assistant | 1530 E Hammer Ln, Stockton, CA 95210 | 2013-08-20 |
| 1285920983 | Supplemental Health Care | Preferred Provider Organization | 8425 Kiltie Wy, Stockton, CA 95210 | 2011-06-22 |
| 1770807901 | Stockton Medical Weight Loss Center Inc | Internal Medicine | 1801 E. March Lane, Suite 400d, Stockton, CA 95210 | 2010-03-17 |
| 1699911412 | Pratap Krishna Anne | Pharmacist | 1801 E.march Ln, Suite:b280, Bjrx, Stockton, CA 95210 | 2008-12-29 |
| Find all providers in zip 95210 | ||||
| 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 |
|---|---|---|---|---|
| 1851901557 | Marcel Evan Acob | Dentist | 3453 Brookside Rd Ste A, Stockton, CA 95219-1788 | 2020-08-06 |
| 1124687314 | Jonathan Gordon Low | Dentist | 3031 W March Ln Ste 340, Stockton, CA 95219-6562 | 2019-06-11 |
| 1649746066 | Rommel K Bal Dds A Dental Corporation | Dentist | 1545 Saint Marks Plz Ste 1, Stockton, CA 95207-6411 | 2018-10-23 |
| 1487130191 | Rassiwala Dental Corporation | Dentist | 2043 E Fremont St Ste 8, Stockton, CA 95205 | 2018-07-16 |
| 1689079501 | Steven Mikkio Otani | Dentist | 618 Lincoln Ctr, Stockton, CA 95207-2639 | 2014-11-04 |
| 1104245398 | Bradley C. Louie, Dds, Inc. | Dentist | 4255 Pacific Ave Ste 1, Stockton, CA 95207-7638 | 2014-04-15 |
| 1497196737 | Nidhi Gupta | Dentist | 7860 West Ln, Stockton, CA 95210-3317 | 2013-07-16 |
| 1992064364 | Quan Vo Anh Nguyen Dds Inc | Dentist | 702 Porter Ave Ste F, Stockton, CA 95207-4297 | 2012-05-04 |
| 1649544404 | Cherie Diana Fiscus | Dentist | 4565 Quail Lakes Dr, Suite A2, Stockton, CA 95207-5294 | 2012-02-26 |
| 1760763767 | Leng C Haong Dds Inc | Dentist | 6323 Pacific Ave, Stockton, CA 95207 | 2011-09-02 |
| Find all providers in STOCKTON | ||||
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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.