PARK DENTAL GROUP (NPI# 1235403700) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1235403700 |
| Entity Type | Organization |
| Organization Name | PARK DENTAL GROUP |
| Other Organization Name | MONROE SMILE CENTER |
| Practice Address |
256 N Hammond Dr Monroe GA 30655-2475 |
| Practice Telephone | 7702070008 |
| Practice Fax Number | 7702070033 |
| Mailing Telephone | 7702070008 |
| Mailing Fax Number | 7702070033 |
| Enumeration Date | 2012-03-01 |
| Last Update Date | 2012-03-01 |
| Authorized Official Name | DR. HYUN W. PARK (GENERAL DENTISTRY) |
| Authorized Official Telephone | 7702070008 |
| Authorized Official Credential | D.D.S |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QD0000X |
Clinic/Center Specialization: Dental |
DN012810 | GA | Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Monroe Smile Center | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114249778 | Park Dental Group | Dentist | 480 Park St, Stoughton, MA 02072-3085 | 2010-02-24 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Massachusetts Corporations | PARK DENTAL GROUP PC | 480 Park St., Stoughton, MA 02072 |
| Street Address |
256 N HAMMOND DR |
| City | MONROE |
| State | GA |
| Zip Code | 30655-2475 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881773679 | Hyun W Park | Dentist | 256 N Hammond Dr, Monroe, GA 30655-2475 | 2006-11-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558968149 | Coresa Hawanis Thomas | Counselor | Advantage Behavioral Health, 384 State Hwy 11 Sw, Walton, GA 30655 | 2020-10-06 |
| 1821629049 | Daniel A Hodges | Dentist | 1190 West Spring St, Suite A, Monroe, GA 30655 | 2020-01-27 |
| 1669019071 | Daniel Bradley Hodges | Dentist | 1190 W. Spring St, Monroe, GA 30655 | 2019-12-04 |
| 1861962730 | Danny Shoemake | Counselor | 2080 Highway 78 Nw, Monroe, GA 30655 | 2018-12-04 |
| 1205329687 | Advantage Behavioral Health Systems | Clinic/Center | 638 Michael Cir., Monroe, GA 30655 | 2018-06-11 |
| 1144722455 | Catherine Williams | Behavioral Analyst | 109 Blaine Street, Monroe, GA 30655 | 2018-03-02 |
| 1588186811 | Francette Dubuche Bernard | Nurse Practitioner | 398 Highway 11, Sw, Monroe, GA 30655 | 2017-07-07 |
| 1437699006 | Amanda Kaye Green | Nurse Practitioner | 517 Great Oaks Drive Suite 103, Monroe, GA 30655 | 2017-03-02 |
| 1639528524 | Matthew Bradford Allgood | Physical Therapist | 2120 W Spring St Ste 1500, Monroe, GA 30655 | 2016-06-10 |
| 1477939221 | Healthy Home Transitions | Social Worker | 506 S Broad Street, Monroe, GA 30655 | 2015-08-04 |
| Find all providers in zip 30655 | ||||
| Taxonomy Code | 261QD0000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Dental |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023228830 | W Randall Cline Dds Pa | Clinic/Center | 2208 Commerce Dr, Monroe, NC 28110-6725 | 2007-05-23 |
| 1194340828 | Monroe Family Dentistry | Clinic/Center | 181 Main St, Monroe, CT 06468-1110 | 2020-06-09 |
| 1255976148 | Adam R Brown Dds, Pllc | Clinic/Center | 704 S Sutherland Ave, Monroe, NC 28112-5065 | 2019-11-14 |
| 1548804560 | Dental Haus of Monroe LLC | Clinic/Center | 1602 11th St, Monroe, WI 53566-2002 | 2019-11-01 |
| 1114582467 | Yunki Cho, Dds, Pllc | Clinic/Center | 1221 W Main St, Monroe, WA 98272-2028 | 2019-05-02 |
| 1669945861 | Jan T Bagwell Dds | Clinic/Center | 189 Keystone Rd, Monroe, LA 71203-8936 | 2019-01-10 |
| 1669943627 | Nelson Dental Ltd | Clinic/Center | 1413 S 2nd St, Monroe, LA 71202-2739 | 2018-12-16 |
| 1831697978 | Nelson Dental LLC | Clinic/Center | 1413 S 2nd St, Monroe, LA 71202-2739 | 2018-01-23 |
| 1245783471 | Joseph Szabo Dds Pllc | Clinic/Center | 809 W Main St Ste A, Monroe, WA 98272-2172 | 2016-07-23 |
| 1982079570 | Monroe Family Dentistry LLC | Clinic/Center | 181 Main St, Monroe, CT 06468-1110 | 2015-12-08 |
| Find all providers in MONROE | ||||
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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.