S PARK DDS INC (NPI# 1558763771) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1558763771 |
| Entity Type | Organization |
| Organization Name | S PARK DDS INC |
| Other Organization Name | GROVE DENTAL GROUP |
| Practice Address |
9727 Elk Grove Florin Rd Ste 155 Elk Grove CA 95624-2291 |
| Mailing Address |
9727 Elk Grove Florin Road Suite 155 Elk Grove CA 95624 |
| Practice Telephone | 9167147771 |
| Practice Fax Number | 9167147779 |
| Mailing Telephone | 9167147771 |
| Mailing Fax Number | 9167147779 |
| Enumeration Date | 2014-09-18 |
| Last Update Date | 2014-09-18 |
| Authorized Official Name | MR. DAVID SANGHO PARK (DENTIST/PRESIDENT) |
| Authorized Official Telephone | 9167147771 |
| 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 |
|---|---|
| Grove Dental Group | Doing Business As Name - Organization |
| Street Address |
9727 ELK GROVE FLORIN RD STE 155 |
| City | ELK GROVE |
| State | CA |
| Zip Code | 95624-2291 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194363721 | Sanam Adela Baidar | Behavior Technician | 9170 Dino Dr, Ste 170, Elk Grove, CA 95624 | 2019-12-13 |
| 1134686041 | Hannah Marie Hamm | Behavior Technician | 9701 Dino Drive, Suite 170, Elk Grove, CA 95624 | 2019-02-27 |
| 1538624259 | Amnah Sattar | Assistant Behavior Analyst | 9701 Dino Dr, Elk Grove, CA 95624 | 2019-02-06 |
| 1740793470 | Sheena Maharaj | Marriage & Family Therapist | 9008 Elk Grove Blvd Ste 11, Elk Grove, CA 95624 | 2017-11-16 |
| 1598285595 | Jessica Russo | Behavior Technician | 8672 Cycladic Ct, Elk Grove, CA 95624 | 2017-06-21 |
| 1982137568 | Jamie Kofoed | Behavioral Analyst | 9355 E Stockton Blvd Ste 100, Elk Grove, CA 95624 | 2017-04-10 |
| 1154878742 | Dorian Elaine Buckner | Counselor | 9355 E. Stockton Blvd., Elk Grove, CA 95624 | 2016-09-01 |
| 1447635529 | David Johnson | Student in an Organized Health Care Education/Training Program | 9666 Kent St, Elk Grove, CA 95624 | 2015-07-30 |
| 1760862437 | Harpreet Singh | Student in an Organized Health Care Education/Training Program | 8617 Orison Ct, Elk Grove, CA 95624 | 2015-06-08 |
| 1942698253 | Noah Shapiro | Social Worker | 9140 Bradshaw Rd, Elf Grove, CA 95624 | 2015-01-08 |
| Find all providers in zip 95624 | ||||
| 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 |
|---|---|---|---|---|
| 1609473719 | G. Sekhon, A Professional Corp | Dentist | 9307 Laguna Springs Dr Ste 110, Elk Grove, CA 95758-7845 | 2020-10-02 |
| 1487208310 | Charles Alfred Benavidez Sr. | Dentist | 8007 Laguna Blvd Ste 3, Elk Grove, CA 95758-8127 | 2019-07-29 |
| 1285286203 | Trevor John Dominic Chen | Dentist | 9117 Trumbauer Way, Elk Grove, CA 95758-7434 | 2019-07-10 |
| 1629535463 | Mona M Ragaie | Dentist | 5500 Mariolyn Way, Elk Grove, CA 95757-1625 | 2019-02-28 |
| 1215410170 | Quoc Christopher Nguyen | Dentist | 4809 Laguna Blvd Ste 90, Elk Grove, CA 95758-7044 | 2018-09-07 |
| 1467806588 | Amardeep Bains | Dentist | 9250 Laguna Springs Drive, Suite 205, Elk Grove, CA 95758 | 2016-04-14 |
| 1578961504 | Laguna Springs Dental | Dentist | 9299 Laguna Springs Dr, #100, Elk Grove, CA 95758-7976 | 2014-12-08 |
| 1174888044 | Roy A Eakin | Dentist | 9345 Boulder River Way, Elk Grove, CA 95624-4052 | 2012-07-06 |
| 1740517580 | Kirk Youngman | Dentist | 8013 Laguna Blvd, Ste #2, Elk Grove, CA 95758-7920 | 2009-11-16 |
| 1730313677 | Chuenchie Chiang | Dentist | 8760 Center Pkwy, G343, Elk Grove, CA 95758-8438 | 2009-05-06 |
| Find all providers in ELK GROVE | ||||
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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.