DR. SUSAN MEKYUNG PARK (NPI# 1306052683) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1306052683 |
| Entity Type | Individual |
| Full Name | DR. SUSAN MEKYUNG PARK |
| Credential | D.D.S. |
| Practice Address |
363 Se 4th Ave Hillsboro OR 97123-4281 |
| Mailing Address |
1255 Nw 9th Ave Apt 803 Portland OR 97209-2896 |
| Practice Telephone | 5036401313 |
| Mailing Telephone | 5033207288 |
| Enumeration Date | 2007-05-15 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223P0300X |
Dentist Specialization: Periodontics |
D8866 | OR | Dental Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598117012 | Susan S Park | Pharmacist | 15131 E Crestline Ave, Centennial, CO 80015-2517 | 2016-07-08 |
| 1104230838 | Susan Park | Dentist | 3607 Old Spanish Trl, Suite G, Houston, TX 77021 | 2014-06-20 |
| 1922253673 | Susan Clair Park | Physical Therapist | 7 Spur Rd, Lansdale, PA 19446-1435 | 2008-11-21 |
| 1467668772 | Susan Yooshin Park | Radiology | 8 Calais, Newport Coast, CA 92657-1055 | 2007-05-15 |
| 1497309413 | Susan S Park | Student in an Organized Health Care Education/Training Program | 5645 Main St, Flushing, NY 11355-5045 | 2019-07-29 |
| 1306309463 | Susan Hahn Park | Speech-Language Pathologist | 2525 Brea Blvd, Fullerton, CA 92835-2787 | 2019-04-07 |
| 1962979989 | Susan S Park | Registered Nurse | 420 S 5th Ave, West Reading, PA 19611-2143 | 2018-10-29 |
| 1609376797 | Susan Young Park | Nurse Practitioner | 2242 Repsdorph Rd, Seabrook, TX 77586-1566 | 2018-02-15 |
| 1114253515 | Susan Jung Park | Family Medicine | 11420 Warner Ave, Fountain Valley, CA 92708-2529 | 2009-10-20 |
| 1003070640 | Susan Jin-sun Park | Family Medicine | 661 Sierra Rose Dr, Reno, NV 89511 | 2008-07-14 |
| Street Address |
363 SE 4TH AVE |
| City | HILLSBORO |
| State | OR |
| Zip Code | 97123-4281 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962524611 | Melvin L. Matsuda | Dentist | 363 Se 4th Ave, Hillsboro, OR 97123-4281 | 2007-04-04 |
| 1952663668 | Michael Loren Matsuda | Dentist | 363 Se 4th Ave, Hillsboro, OR 97123-4281 | 2012-06-10 |
| 1043428436 | Melvin L. Matsuda Dds PC | Dentist | 363 Se 4th Ave, Hillsboro, OR 97140-4281 | 2007-05-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851916241 | Gabriel Lawrence | Physical Therapist | 2973 Se 79th Ave., Hillsboro, OR 97123 | 2020-06-11 |
| 1487278453 | Jordan Gregory Evans | Student in an Organized Health Care Education/Training Program | Creighton Hall 222 Se 8th Ave, Hillsboro, OR 97123 | 2020-06-04 |
| 1124641006 | Jessica Anne Bramlett | Student in an Organized Health Care Education/Training Program | 228 Southeast 8th Avenue, Suite 536, Hillsboro, OR 97123 | 2020-05-26 |
| 1003448168 | Madelyn Vogt | Community Health Worker | 862 Se Oak Street, Suite 2a, Hillsboro, OR 97123 | 2020-02-06 |
| 1215435789 | Renise Harrel | Massage Therapist | 4855 Se Tv Hwy, Suite B, Hillsboro, OR 97123 | 2018-01-30 |
| 1497260269 | Amy Hodges | Counselor | 222 Se 8th Ave # 212, Hillsboro, OR 97123 | 2017-12-02 |
| 1033623723 | Tamira L Heyob | Doula | 25600 Sw Bald Peak Rd., Hillsboro, OR 97123 | 2017-11-17 |
| 1134644024 | Tara Kyoko Taylor | Massage Therapist | 5289 Ne Elam Young Pkwy #130, Hillsboro, OR 97123 | 2017-08-11 |
| 1023543055 | Austin Simpson | Counselor | 222 Se 8th, Suite 222, Hillsboro, OR 97123 | 2017-04-27 |
| 1124569769 | Emergency Tooth Doctor Hillsboro, Prof. Corp. | Dentist | 752 Se Oak St, Hillsboro, OR 97123 | 2017-03-15 |
| Find all providers in zip 97123 | ||||
| Taxonomy Code | 1223P0300X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Periodontics |
| That specialty of dentistry which encompasses the prevention, diagnosis and treatment of diseases of the supporting and surrounding tissues of the teeth or their substitutes and the maintenance of the health, function and esthetics of these structures and tissues. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962524611 | Melvin L. Matsuda | Dentist | 363 Se 4th Ave, Hillsboro, OR 97123-4281 | 2007-04-04 |
| 1952663668 | Michael Loren Matsuda | Dentist | 363 Se 4th Ave, Hillsboro, OR 97123-4281 | 2012-06-10 |
| 1043428436 | Melvin L. Matsuda Dds PC | Dentist | 363 Se 4th Ave, Hillsboro, OR 97140-4281 | 2007-05-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871026062 | Leila Soltani | Dentist | 430 Sw 13th Ave Apt 2010, Portland, OR 97205 | 2017-04-05 |
| 1427504828 | Shashank Joshi | Dentist | 1739 W Harvard Ave, Roseburg, OR 97471-2716 | 2016-08-26 |
| 1982056479 | Mari Heslinga | Dentist | 21332 Sw Langer Farms Pkwy Ste 126, Sherwood, OR 97140 | 2016-07-07 |
| 1376944314 | Mikhail Garibov | Dentist | 17895 Nw Evergreen Pkwy Ste 130, Beaverton, OR 97006-7402 | 2014-09-09 |
| 1548671340 | Polaris Dental Specialists | Dentist | 620 12th Street Se, Salem, OR 97301 | 2014-05-14 |
| 1295159986 | Andrew N Dow Dmd PC | Dentist | 4750 Village Plaza Loop Ste 102, Eugene, OR 97401-6601 | 2014-02-14 |
| 1043581465 | Riverplace Periodontics PC | Dentist | 2636 Se Harrison Street, Suite A, Milwaukie, OR 97222 | 2012-01-17 |
| 1730472986 | Wilson D Lee | Dentist | 315 Nw Lost Springs Ter, #401, Portland, OR 97229-6444 | 2011-05-20 |
| 1184954422 | Kamran Haghighat Bds Ms PC | Dentist | 833 Sw 11th Ave Ste 1020, Portland, OR 97205-2124 | 2010-01-08 |
| 1467683276 | Sunny L Drake | Dentist | 2235 Mission St Se Ste 250, Salem, OR 97302-1294 | 2009-07-29 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on DR. SUSAN MEKYUNG PARK.
| 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.