DR D S PARK DENTAL INC (NPI# 1760025589) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1760025589 |
| Entity Type | Organization |
| Organization Name | DR D S PARK DENTAL INC |
| Practice Address |
1245 7th St Wasco CA 93280-1820 |
| Practice Telephone | 6617583021 |
| Practice Fax Number | 6617586780 |
| Mailing Telephone | 6617583021 |
| Mailing Fax Number | 6617586780 |
| Enumeration Date | 2019-10-24 |
| Last Update Date | 2019-10-24 |
| Authorized Official Name | DR. DAVID S PARK (OWNER) |
| Authorized Official Telephone | 3104031117 |
| Authorized Official Credential | DDS |
| Is Organization Subpart | Y |
| Parent Organization Name | DR D S PARK DENTAL INC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 122300000X | Dentist | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | 53724 | 05 |
| Other Name | Type Code |
|---|---|
| Smile Dental of Wasco | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477196244 | Dr D S Park Dental Inc | Dentist | 1406 Jefferson St, Delano, CA 93215-2222 | 2019-10-23 |
| Street Address |
1245 7TH ST |
| City | WASCO |
| State | CA |
| Zip Code | 93280-1820 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881801975 | Brian Songsu Kim | Dentist | 1245 7th St, Wasco, CA 93280-1820 | 2007-05-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609411461 | Juan Louis Castillo Jr. | Case Manager/Care Coordinator | 29341 Kimberlina Road Suite 102, Wasco, CA 93280 | 2019-11-15 |
| 1346768108 | Crystal Magana | Case Manager/Care Coordinator | 930 F St., Wasco, CA 93280 | 2017-08-31 |
| 1669914099 | Noemi Elizondo | Marriage & Family Therapist | 29341 Suite 102 Kimberlina Road, Wasco, CA 93280 | 2016-11-16 |
| 1437431376 | Javier Barba | Counselor | 29325 Kimberlina Rd., Wasco, CA 93280 | 2011-09-16 |
| 1235381724 | Maribel Pelayo | Counselor | 1217 7th Street, Wasco, CA 93280 | 2008-10-16 |
| 1194909218 | Lourdes Garza I | Counselor | 29325 Kimberlina Rd, Wasco, CA 93280 | 2007-12-26 |
| 1396876397 | Mike Mais Sagarian | Dentist | 1229 7-th St., Wasco, CA 93280 | 2007-03-08 |
| 1588791495 | Walter Patton II | Counselor | 29325 Kimberlina Road, Wasco, CA 93280 | 2007-02-27 |
| 1982739298 | Donna Antoinette Rede | Social Worker | 29325 Kimberling Rd., Wasco, CA 93280 | 2007-02-23 |
| 1568949576 | Raymond Antonio Martinez Guzman | Counselor | 930 F St, Wasco, CA 93280 | 2018-07-23 |
| Find all providers in zip 93280 | ||||
| Taxonomy Code | 122300000X |
| Grouping | Dental Providers |
| Classification | Dentist |
| A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598946196 | Joseph S. Lo | Dentist | 701 Scofield Ave, Dental Dept., Wasco, CA 93280-7515 | 2007-11-25 |
| 1336346287 | Dennis L Gibbs | Dentist | Wasco State Prison, 701 Scofield Ave, Wasco, CA 93280-8800 | 2007-07-02 |
| 1689727703 | Jae Geun Jang | Dentist | 701 Scofield Ave, Wasco, CA 93280-7515 | 2007-01-19 |
| 1740369180 | Inas I. Michael | Dentist | 701 Scofield Ave, Wasco, CA 93280-7515 | 2006-11-05 |
| 1063437853 | Georgetta Molnar | Dentist | 2101 7th St, Wasco, CA 93280 | 2006-07-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306447057 | Sienna Palmer Ogbevoen Dds, Inc. | Dentist | 27871 Medical Center Rd Ste 290, Mission Viejo, CA 92691-6440 | 2020-11-07 |
| 1821699737 | William Bill Ngo | Dentist | 1591 Griffin Road Mcagcc, Twentynine Palms, CA 92277 | 2020-11-06 |
| 1134720022 | Iee Shin | Dentist | 30406 Haun Rd Ste 740, Menifee, CA 92584-6816 | 2020-11-05 |
| 1568063634 | Western Dental Services, Inc. | Dentist | 2537 S Euclid Ave Ste A, Ontario, CA 91762-6620 | 2020-11-05 |
| 1467053660 | Gurjot Sidhu Dds Dental Corporation | Dentist | 2701 E Hammer Ln Ste 101, Stockton, CA 95210-4245 | 2020-11-04 |
| 1821699133 | Ayesha Ahmad | Dentist | 4910 Chapparal Way, Banning, CA 92220-3353 | 2020-11-03 |
| 1407457856 | Yiyang Zou | Dentist | 333 W El Camino Real Ste 260, Sunnyvale, CA 94087-8127 | 2020-11-03 |
| 1851992481 | Centinela Joseph Dental Group | Dentist | 6907 La Tijera Blvd, Los Angeles, CA 90045-1906 | 2020-11-02 |
| 1518568138 | Raime Shah | Dentist | 707 Parnassus Ave Ste D-3000, San Francisco, CA 94143-2210 | 2020-11-02 |
| 1558961359 | Tony Tataro | Dentist | 5700 Village Oaks Dr Apt 1222, San Jose, CA 95123-3771 | 2020-10-29 |
| Find all providers with the same taxonomy | ||||
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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.