PARK DENTAL ASSOCIATES P.C. (NPI# 1164709093) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1164709093 |
| Entity Type | Organization |
| Organization Name | PARK DENTAL ASSOCIATES P.C. |
| Practice Address |
1512 Sansom St #300 Philadelphia PA 19102-2809 |
| Practice Telephone | 2155640717 |
| Practice Fax Number | 2155645450 |
| Mailing Telephone | 2155640717 |
| Mailing Fax Number | 2155645450 |
| Enumeration Date | 2011-11-06 |
| Last Update Date | 2011-11-06 |
| Authorized Official Name | DR. YEUN-JUNE PARK (PRESIDENT/PROSTHODONTIST) |
| Authorized Official Telephone | 2155640717 |
| Authorized Official Credential | DMD, MSD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223P0700X |
Dentist Specialization: Prosthodontics |
DS035815 | PA | Dental Providers |
| Street Address |
1512 SANSOM ST #300 |
| City | PHILADELPHIA |
| State | PA |
| Zip Code | 19102-2809 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457482812 | Yeun-june Park | Dentist | 1512 Sansom St, #300, Philadelphia, PA 19102-2809 | 2007-03-08 |
| 1194944975 | Linda G Johnson | Dentist | 1512 Sansom St, Philadelphia, PA 19102-2804 | 2007-04-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821650847 | Alexandre Mason Sharma | Student in an Organized Health Care Education/Training Program | 200 N 16th St Apt 1318, Philadelphia, PA 19102 | 2019-06-29 |
| 1720648223 | Ali Haydar | Internal Medicine | 245 N. 15th St, 6th Floor, Ms 42, Philadelphia, PA 19102 | 2019-06-17 |
| 1124688734 | Aakash Patel | Internal Medicine | Drexel University College of Medicine-internal Medicine, 245 N. 15th St. 6th Floor, Ms 427, Philadelphia, PA 19102 | 2019-06-17 |
| 1245898170 | Parth Javia | Internal Medicine | 245 N. 15th St., 6th Floor, Ms 427, Philadelphia, PA 19102 | 2019-06-05 |
| 1588120968 | John Granger II | Social Worker | 1500 Market St. 12th Floor Suite 75, Philadelphia, PA 19102 | 2019-02-11 |
| 1750851390 | Philadelphia Pain and Neurology Institute, LLC | Chiropractor | 1528 Walnut Street Suite 620, Philadelphia, PA 19102 | 2018-11-27 |
| 1770076465 | Sarthi Dalal | Internal Medicine | 245 N 15th St, Fl 6, Ms 427, Philadelphia, PA 19102 | 2018-06-07 |
| 1255824033 | Joyce Nimo-boampong | Internal Medicine | Drexel University College of Medicine, 245 N 15th St, 6th Floor,ms 427, Philadelphia, PA 19102 | 2018-06-07 |
| 1134625692 | Emma Rose Gormley | Social Worker | 1601 Walnut St Ste 1516, Philadelphia, PA 19102 | 2018-04-03 |
| 1851808497 | Sunish Shah | Pharmacist | 230 N Broad St, Philadelphia, Pa 19102, Philadelphia, PA 19102 | 2018-01-04 |
| Find all providers in zip 19102 | ||||
| Taxonomy Code | 1223P0700X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Prosthodontics |
| That branch of dentistry pertaining to the restoration and maintenance of oral functions, comfort, appearance and health of the patient by the restoration of natural teeth and/or the replacement of missing teeth and contiguous oral and maxillofacial tissues with artificial substitutes. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831426196 | David J. Fox, D.m.d., P.C. | Dentist | 2401 Pennsylvania Ave Ste 1a8, Philadelphia, PA 19130-3002 | 2009-11-06 |
| 1720246648 | Leslie Stone Stone Hirsh | Dentist | 1420 Locust Street, Suite 120, Philadelphia, PA 19102 | 2008-05-28 |
| 1982883575 | Vicki C Petropoulos | Dentist | 220 S 40th St Ste 201c, Philadelphia, PA 19104-3543 | 2007-10-31 |
| 1457482812 | Yeun-june Park | Dentist | 1512 Sansom St, #300, Philadelphia, PA 19102-2809 | 2007-03-08 |
| 1609906163 | Richard S Vanni Jr. | Dentist | 2867 Holme Ave, Philadelphia, PA 19152-2118 | 2007-03-06 |
| 1881707438 | Prosthodontics Limited, PC | Dentist | 8021 Castor Ave, Suite B, Philadelphia, PA 19152-2733 | 2006-08-17 |
| 1821034588 | Najeed Saleh | Dentist | 240 S 40th St, Philadelphia, PA 19104-6030 | 2006-06-21 |
| 1023626413 | Amsterdam, Weisgold, Baumgarten, Ingber, & Fraiman | Dentist | 100 S Broad St Ste 2000, Philadelphia, PA 19110-1009 | 2020-07-21 |
| 1346778651 | Loren Nicole Genetti | Dentist | 8021b Castor Ave, Philadelphia, PA 19152-2733 | 2017-05-31 |
| 1699088534 | Evanthia Anadioti | Dentist | 240 S 40th St, Philadelphia, PA 19104-6030 | 2010-07-20 |
| Find all providers in PHILADELPHIA | ||||
| City | PHILADELPHIA |
| Zip Code | 19102 |
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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.