DR. CHANG SOON PARK (NPI# 1740562883) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1740562883 |
| Entity Type | Individual |
| Full Name | DR. CHANG SOON PARK |
| Credential | D.M.D. |
| Practice Address |
1319 Lincoln Ave Prospect Park PA 19076-1216 |
| Mailing Address |
3 Old Covered Bridge Rd Newtown Square PA 19073-1211 |
| Practice Telephone | 6105325008 |
| Enumeration Date | 2011-09-14 |
| Last Update Date | 2013-08-05 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
DS039272 | PA | Dental Providers |
| N | 1223G0001X |
Dentist Specialization: General Practice |
60669 | CA | Dental Providers |
| N | 1223G0001X |
Dentist Specialization: General Practice |
055756 | NY | Dental Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740629948 | Chang S Park | Internal Medicine | 200 Old Palisade Rd Apt 1e, Fort Lee, NJ 07024-7057 | 2013-06-20 |
| 1134309891 | Chang W Park | Acupuncturist | 975 S Vermont Ave, Suite #201, Los Angeles, CA 90006-5906 | 2007-11-11 |
| 1174699763 | Chang Sik Park | Acupuncturist | 100 E Thousand Oaks Blvd Ste 250, Thousand Oaks, CA 91360-8150 | 2006-11-27 |
| 1306188628 | Chang Park | Anesthesiology | 1 Gustave L Levy Pl # 1010, New York, NY 10029-6504 | 2013-03-25 |
| 1710040811 | Chang J Park | Obstetrics & Gynecology | 3003 New Hyde Park Rd, #312, New Hyde Park, NY 11042 | 2006-12-19 |
| 1164529590 | Chang Park | Chiropractor | 241 Golf Mill Ctr, Suite # 424, Niles, IL 60714-1224 | 2006-09-20 |
| Street Address |
1319 LINCOLN AVE |
| City | PROSPECT PARK |
| State | PA |
| Zip Code | 19076-1216 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710142625 | Rapozafamily Dentistry | Dentist | 1319 Lincoln Ave, Prospect Park, PA 19076-1216 | 2008-07-21 |
| 1144679499 | Wilson Phillips | Dentist | 1319 Lincoln Ave, Prospect Park, PA 19076-1216 | 2016-06-07 |
| 1932558624 | Jared Gittleman | Dentist | 1319 Lincoln Ave, Prospect Park, PA 19076-1216 | 2016-06-03 |
| 1336523141 | Anthony Jeffrey Rapoza | Dentist | 1319 Lincoln Ave, Prospect Park, PA 19076-1216 | 2015-07-13 |
| 1184985640 | Katerina Sioutis | Dentist | 1319 Lincoln Ave, Prospect Park, PA 19076-1216 | 2012-05-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043616824 | Krista Mcshea Todd-burke | Occupational Therapist | 815 Chester Pike, Prospect Park Health and Rehabilitation Center, Prospect Park, PA 19076 | 2014-11-06 |
| 1558573774 | Family Chiropractic Wellness Center | Chiropractor | 625 Chester Pike, Prospect Park, PA 19076 | 2007-05-03 |
| 1265521900 | Rite Aid of Pennsylvania LLC | Durable Medical Equipment & Medical Supplies | 762 Chester Pike, Prospect Park, PA 19076-0000 | 2006-10-12 |
| 1205453719 | Delaney Hallowell | Physician Assistant | 547 13th Ave, Prospect Park, PA 19076-1101 | 2020-06-30 |
| 1750633848 | Progressive Health Inc | Home Health | 705 15th Ave, Prospect Park, PA 19076-1105 | 2012-10-12 |
| 1538377551 | Health Access Network | Internal Medicine | 1401 Lincoln Ave, Prospect Park, PA 19076-1107 | 2007-05-21 |
| 1730185950 | Mukesh A Patel | Internal Medicine | 1421 Lincoln Ave, Prospect Park, PA 19076-1107 | 2005-06-22 |
| 1194019166 | Mukesh Patel M.d | Internal Medicine | 1421 Lincoln Ave, Prospect Park, PA 19076-1107 | 2011-06-07 |
| 1477093409 | Jenna Syken | Prevention Professional | 500 16th Ave, Prospect Park, PA 19076-1120 | 2017-02-23 |
| 1467065284 | Holcomb Associates Inc. | Clinic/Center | 500 16th Ave, Prospect Park, PA 19076-1120 | 2020-08-31 |
| Find all providers in zip 19076 | ||||
| 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 |
|---|---|---|---|---|
| 1124207246 | Shweta Gandhi | Dentist | 338 Lincoln Ave, Prospect Park, PA 19076-2421 | 2007-10-25 |
| 1619179595 | Wassim Alwan | Dentist | 222 Haledon Ave, Prospect Park, NJ 07508-2024 | 2007-06-04 |
| 1992851240 | Richard N Benjamin Dds PC | Dentist | 907 Lincoln Ave, Prospect Park, PA 19076-1414 | 2007-01-26 |
| 1245317296 | Jawdat Varoqua | Dentist | 318 Haledon Ave, Prospect Park, NJ 07508 | 2006-11-01 |
| 1336523141 | Anthony Jeffrey Rapoza | Dentist | 1319 Lincoln Ave, Prospect Park, PA 19076-1216 | 2015-07-13 |
| 1184985640 | Katerina Sioutis | Dentist | 1319 Lincoln Ave, Prospect Park, PA 19076-1216 | 2012-05-31 |
| 1538434592 | Michael Alan Green | Dentist | 338 Lincoln Ave, Prospect Park, PA 19076-2421 | 2012-03-09 |
| 1639371347 | Khaled Y Alwan | Dentist | 222 Haledon Ave, Prospect Park, NJ 07508-2024 | 2007-06-04 |
| 1891831137 | Richard N Benjamin | Dentist | 907 Lincoln Ave, Prospect Park, PA 19076-1414 | 2007-01-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538760087 | Rg Dental Group of Richboro, LLC | Dentist | 56 Newtown Richboro Rd., Suite 1, Richboro, PA 18954 | 2020-11-02 |
| 1790385581 | Samir Zahedpasha | Dentist | 1933 Delancey Pl, Philadelphia, PA 19103-6611 | 2020-10-29 |
| 1225636087 | Clark Dental Associates, LLC | Dentist | 7 Bala Ave Ste 301, Bala Cynwyd, PA 19004-3205 | 2020-10-14 |
| 1336747450 | Drexel Hill Smiles PC | Dentist | 4605 State Rd, Drexel Hill, PA 19026-4423 | 2020-10-12 |
| 1568074631 | Haley Ciccarelli | Dentist | 3475 W Chester Pike Ste 220, Newtown Square, PA 19073-4291 | 2020-08-20 |
| 1770195000 | Steven Dodson | Dentist | 7573 Woodbury Pike, Roaring Spring, PA 16673-1601 | 2020-08-18 |
| 1376154807 | Katherine Marie Stranieri | Dentist | 127 S Spring Garden St, Ambler, PA 19002-4726 | 2020-08-10 |
| 1407466162 | Christa A Musto | Dentist | 575 Pierce St Ste 201, Kingston, PA 18704-5700 | 2020-08-06 |
| 1669082632 | Nepa Dental Group, Inc | Dentist | 920 Wyoming Ave Ste 104, Forty Fort, PA 18704-3970 | 2020-08-05 |
| 1184234023 | Bucks County Dental Design, PC | Dentist | 95 Almshouse Rd Ste 201, Richboro, PA 18954-1155 | 2020-08-05 |
| Find all providers with the same taxonomy | ||||
| City | PROSPECT PARK |
| Zip Code | 19076 |
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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.