DR PARK DENTAL CORPORATION (NPI# 1790263465) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790263465 |
| Entity Type | Organization |
| Organization Name | DR PARK DENTAL CORPORATION |
| Other Organization Name | WEST AV DENTAL GROUP |
| Practice Address |
38745 Tierra Subida Ave Ste 150 Palmdale CA 93551-4567 |
| Mailing Address |
1669 W Avenue J Ste 305 Lancaster CA 93534-2870 |
| Practice Telephone | 6612729091 |
| Mailing Telephone | 6618027544 |
| Enumeration Date | 2018-08-03 |
| Last Update Date | 2018-08-03 |
| Authorized Official Name | DR. DAVID PARK (CEO) |
| Authorized Official Telephone | 3104031117 |
| Authorized Official Credential | DDS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 122300000X | Dentist | 53724 | CA | Dental Providers |
| Other Name | Type Code |
|---|---|
| West AV Dental Group | Doing Business As Name - Organization |
| Street Address |
38745 TIERRA SUBIDA AVE STE 150 |
| City | PALMDALE |
| State | CA |
| Zip Code | 93551-4567 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518578251 | Epak LLC | Registered Nurse | 6327 Giovanni Way, Palmdale, CA 93551 | 2020-08-16 |
| 1710500483 | Hmg Community Clinic Inc | Family Medicine | 38900 Trade Center Drive Suite B, Palmdale, CA 93551 | 2020-05-28 |
| 1891338372 | Babak Yousefi & Fariborz Rodef Dental Corporation | Dentist | 623 West Ave Q Suite #b, Palmdale, CA 93551 | 2019-10-28 |
| 1770052748 | The Kibbutz - Nature Serenity Renewal | Clinic/Center | 13136 Elizabeth Lake Rd, Leona Valley, CA 93551 | 2018-11-19 |
| 1306321872 | Vicky Elena Ledesma | Case Manager/Care Coordinator | 251 Grand Cypress Ave, Palmdale, CA 93551 | 2018-10-01 |
| 1972025898 | Tamika Estrella | Driver | 39553 Hawthorne St, Palmdale, CA 93551 | 2017-07-12 |
| 1245750751 | Tamara Vwich Dds Inc | Dentist | 3011 Rancho Vista Blvd., Suite I, Palmdale, CA 93551 | 2017-06-26 |
| 1487003356 | Thriving Consultingname | Home Health | 2845 Ladyfern Lane, Palmdale, CA 93551 | 2016-06-10 |
| 1235501750 | Jessica Andrea Ulloa | Counselor | 734 Celtic Dr, Palmdale, CA 93551 | 2015-10-23 |
| 1508240243 | Rachel Williams | Registered Nurse | 3961 Woburn Ct, Palmdale, CA 93551 | 2015-07-13 |
| Find all providers in zip 93551 | ||||
| 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 |
|---|---|---|---|---|
| 1699388561 | Western Dental Services, Inc. | Dentist | 37134 47th St E Ste A&b, Palmdale, CA 93552-4458 | 2020-08-28 |
| 1346727666 | Chris Khatchaturian Dds Inc. | Dentist | 2508 E Palmdale Blvd Ste D, Palmdale, CA 93550-4860 | 2018-07-20 |
| 1245750751 | Tamara Vwich Dds Inc | Dentist | 3011 Rancho Vista Blvd., Suite I, Palmdale, CA 93551 | 2017-06-26 |
| 1043768773 | Nathaniel Hassan | Dentist | 38209 47th St E Ste E, Palmdale, CA 93552-3113 | 2016-09-12 |
| 1326423575 | Trieu & Kang Professional Dental Corp | Dentist | 38024 47th Street, Suite H, Palmdale, CA 93552 | 2015-07-29 |
| 1215312715 | Lilia H. Rivas, Dds, Inc. | Dentist | 5826 Saint Laurent Dr, Palmdale, CA 93552-3318 | 2015-07-25 |
| 1356762934 | April Buckins | Dentist | 2140 E Palmdale Blvd # 1, Palmdale, CA 93550-1202 | 2013-12-26 |
| 1851650543 | Richard Rojas D.d.s. and Richard Rothstein Dds Inc | Dentist | 1154 E. Palmdale Blvd., Palmdale, CA 93550 | 2012-05-15 |
| 1336461789 | Jorge Alberto Flores | Dentist | 509 E. Palmdale B1., Ste E, Palmdale, CA 93550 | 2010-02-25 |
| 1700115342 | Song Kyun Kim | Dentist | 4635 E Avenue S, Ste C102-103, Palmdale, CA 93552 | 2009-12-10 |
| Find all providers in PALMDALE | ||||
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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.