SUSAN PARK (NPI# 1821147190) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1821147190 |
| Entity Type | Individual |
| Full Name | SUSAN PARK |
| Credential | DDS |
| Practice Address |
709 N Main St North Syracuse NY 13212-1669 |
| Mailing Address |
3850 N Causeway Blvd Suite 800 Metairie LA 70002-1752 |
| Practice Telephone | 3154525915 |
| Mailing Telephone | 8006227645 |
| Enumeration Date | 2007-01-09 |
| Last Update Date | 2010-08-24 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223X0400X |
Dentist Specialization: Orthodontics and Dentofacial Orthopedics |
048609-1 | NY | 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 |
709 N MAIN ST |
| City | NORTH SYRACUSE |
| State | NY |
| Zip Code | 13212-1669 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396387288 | Hannah Inglish | Massage Therapist | 709 N Main St, North Syracuse, NY 13212-1669 | 2019-10-11 |
| 1437717725 | Olivia Sandford | Massage Therapist | 709 N Main St, North Syracuse, NY 13212-1669 | 2019-05-31 |
| 1811452378 | Jason P Kelly | Massage Therapist | 709 N Main St, North Syracuse, NY 13212-1669 | 2019-02-08 |
| 1528523164 | Terry Taylor | Massage Therapist | 709 N Main St, North Syracuse, NY 13212-1669 | 2019-02-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750845749 | Branches of Growth Mental Health Counseling, Pllc | Counselor | 3709 Brewerton Rd, Syracruse, NY 13212 | 2019-01-24 |
| 1821574070 | Nadia Marie James | Licensed Practical Nurse | 7175 Rose Wood Circle, North Syracuse, NY 13212 | 2018-07-11 |
| 1306364534 | Shonna Jolene Brodhead | Social Worker | Brightpath Counseling, 7266 Buckley Road, North Syracuse, NY 13212 | 2017-09-08 |
| 1477915189 | Karen Filapello | Speech-Language Pathologist | 320 Gateway Park Drive, @ Precision Contractors, N. Syracuse, NY 13212 | 2016-03-22 |
| 1285017095 | Lacey Foster | Skilled Nursing Facility | 5991 East Taft Rd, North Syracuse, NY 13212 | 2015-06-30 |
| 1346500345 | Wahienhawi Hall | Counselor | 7266 Buckley Rd., Bright Path Counseling Center, North Syracuse, NY 13212 | 2012-05-23 |
| 1316253768 | Jenny Barnum | Nurse Practitioner | 5232 Witz Dr, North Syracuse, NY 13212 | 2010-08-24 |
| 1063738797 | Gregory 'greg' Procopio | Registered Nurse | 308 Charlane Parkway, North Syracuse, NY 13212 | 2010-04-20 |
| 1316142243 | Carrie Marie Vincent | Specialist | 401north Main Street, North Syracuse, NY 13212 | 2007-06-20 |
| 1245307594 | Lynda Robin Kreitzer | Podiatrist | 316 South Main Street, North Syracuse, NY 13212 | 2006-11-30 |
| Find all providers in zip 13212 | ||||
| Taxonomy Code | 1223X0400X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Orthodontics and Dentofacial Orthopedics |
| That area of dentistry concerned with the supervision, guidance and correction of the growing or mature dentofacial structures, including those conditions that require movement of teeth or correction of malrelationships and malformations of their related structures and the adjustment of relationships between and among teeth and facial bones by the application of forces and/or the stimulation and redirection of functional forces within the craniofacial complex. Major responsibilities of orthodontic practice include the diagnosis, prevention, interception and treatment of all forms of malocclusion of the teeth and associated alterations in their surrounding structures; the design, application and control of functional and corrective appliances; and the guidance of the dentition and its supporting structures to attain and maintain optimum occlusal relations in physiologic and esthetic harmony among facial and cranial structures. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023616356 | Nathan Light | Dentist | M Dental Care PC, 337 Lenox Ave, New York, NY 10027 | 2020-10-09 |
| 1467069575 | Thomas P. Shannon, Dds, Professional Corporation | Dentist | 44 W 28th St Fl 14, New York, NY 10001-4212 | 2020-09-23 |
| 1508471665 | Daniella Davis | Dentist | 500 Portion Rd Ste 15, Lake Ronkonkoma, NY 11779-4587 | 2020-09-14 |
| 1144835927 | Nikhil Narkhede | Dentist | 401 Columbus Ave Ste 100, Valhalla, NY 10595-1349 | 2020-09-09 |
| 1619580040 | Amanda Beth Albin | Dentist | 62 Lake Ave S Ste A, Nesconset, NY 11767-1094 | 2020-08-25 |
| 1770109589 | Empire State Orthodontics, P.C. | Dentist | 2840 Military Rd, Niagara Falls, NY 14304-1566 | 2020-06-18 |
| 1457986044 | Todd Weinberger | Dentist | 1097 Old Country Rd Ste 203, Plainview, NY 11803-6505 | 2020-03-04 |
| 1851926513 | Miang Chneh C Teo | Dentist | 1100 Pelham Pkwy S, Bronx, NY 10461-1001 | 2020-03-03 |
| 1871127209 | Parisa Zare | Dentist | 40 Waterside Plz Apt 23e, New York, NY 10010-2633 | 2020-02-25 |
| 1427680776 | Sfc Orthodontics P.C. | Dentist | 738 58th St., 1st Floor, Brooklyn, NY 11220 | 2020-02-05 |
| Find all providers with the same taxonomy | ||||
| City | NORTH SYRACUSE |
| Zip Code | 13212 |
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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.