DR. SE HA PARK (NPI# 1821611989) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1821611989 |
| Entity Type | Individual |
| Full Name | DR. SE HA PARK |
| Credential | DMD |
| Practice Address |
4881 Sugar Maple Dr Dayton OH 45433-5529 |
| Mailing Address |
15021 Greymont Dr Centreville VA 20120-1522 |
| Practice Telephone | 7036221217 |
| Mailing Telephone | 7036221217 |
| Enumeration Date | 2020-05-24 |
| Last Update Date | 2020-05-24 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| Street Address |
4881 SUGAR MAPLE DR |
| City | DAYTON |
| State | OH |
| Zip Code | 45433-5529 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841812898 | George Manoj Paul | Student in an Organized Health Care Education/Training Program | 4881 Sugar Maple Dr, Dayton, OH 45433-5529 | 2020-05-13 |
| 1053949198 | Jacob Aaron Freeze | Student in an Organized Health Care Education/Training Program | 4881 Sugar Maple Dr, Dayton, OH 45433-5529 | 2020-04-01 |
| 1326672619 | Caleb Evan Mcclary | Military Health Care Provider | 4881 Sugar Maple Dr, Dayton, OH 45433-5529 | 2020-02-26 |
| 1730729542 | Alan Eric Piper | Military Health Care Provider | 4881 Sugar Maple Dr, Dayton, OH 45433-5529 | 2020-01-09 |
| 1073161147 | Kristin Kim | Dentist | 4881 Sugar Maple Dr, Dayton, OH 45433-5529 | 2019-08-30 |
| 1225681117 | Kaleb Aaron Specht | Military Health Care Provider | 4881 Sugar Maple Dr, Dayton, OH 45433-5529 | 2019-07-19 |
| 1891347662 | Jessica Marie Gregor | Physician Assistant | 4881 Sugar Maple Dr, Dayton, OH 45433-5529 | 2019-07-11 |
| 1134785165 | Ethan Wilston | Student in an Organized Health Care Education/Training Program | 4881 Sugar Maple Dr, Dayton, OH 45433-5529 | 2019-05-15 |
| 1700381522 | Zachary Gordon Candela | Student in an Organized Health Care Education/Training Program | 4881 Sugar Maple Dr, Dayton, OH 45433-5529 | 2018-03-25 |
| 1285135145 | Brant William Bickford | Student in an Organized Health Care Education/Training Program | 4881 Sugar Maple Dr, Dayton, OH 45433-5529 | 2018-02-26 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891289518 | Sara Lyons | Physician Assistant | 88 Mdj/sghj, 4881 Sugar Maple Dr, Wright-patterson Afb, OH 45433 | 2018-06-16 |
| 1073001558 | Mega Margapuram | Student in an Organized Health Care Education/Training Program | 1 Sugar Maple Drive, Dayton, OH 45433 | 2018-04-30 |
| 1437667979 | Michael Peter Dring | Social Worker | Building 830, Credentials Office, 4881 Sugar Maple Rd, Wpafb, OH 45433 | 2018-01-18 |
| 1316486814 | Josiah Hardin | Internal Medicine | 88 Mdos/sgomi, 4881 Sugar Maple Dr., Wright-patterson Afb, OH 45433 | 2017-02-16 |
| 1780137380 | Allison Osterfeld | Pharmacist | 88 Mdg 4881 Suga Maple Dr, Wright Patterson Afb, OH 45433 | 2016-07-29 |
| 1891144283 | Kyle Harris | Student in an Organized Health Care Education/Training Program | 4481 Sugar Maple Dr., Wright Patterson Afb, OH 45433 | 2016-06-07 |
| 1245601756 | Nichole Griep | Audiologist | 88 Mdg/sgpq, 4881 Sugar Maple Dr, Wright-patterson Afb, OH 45433 | 2015-10-09 |
| 1487021267 | Melanie Schaffer | Dietitian, Registered | 4881 Sugamaple Drive, Wpafb, OH 45433 | 2015-08-27 |
| 1831582261 | Joseph K Wray | General Practice | 88 Mdg/sgcj, 4881 Sugar Maple Dr., Wright-patterson Afb, OH 45433 | 2015-03-10 |
| 1659798031 | Maninder Kaur | Nurse Practitioner | 88 Mdos/sgom, 4881 Sugar Maple Drive, Wright Patterson Afb, OH 45433 | 2014-03-24 |
| Find all providers in zip 45433 | ||||
| Taxonomy Code | 390200000X |
| Grouping | Student, Health Care |
| Classification | Student in an Organized Health Care Education/Training Program |
| An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |
| Notes: [1/1/2005: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205434925 | Madeline Mae Juergens | Student in an Organized Health Care Education/Training Program | 3600 Colonel Glenn Hwy 117 Health Sciences Bldg, Dayton, OH 45435-0001 | 2020-10-14 |
| 1932729662 | Benjamin Mallicoat | Student in an Organized Health Care Education/Training Program | 128 E Apple St Ste 2800, Dayton, OH 45409-2902 | 2020-04-22 |
| 1306465877 | Chase Smith | Student in an Organized Health Care Education/Training Program | 4100 W 3rd St Bldg 330, Dayton, OH 45428-9000 | 2020-04-14 |
| 1255960233 | Landon Rosevear | Student in an Organized Health Care Education/Training Program | 128 E Apple St Fl 7, Dayton, OH 45409-2902 | 2020-04-02 |
| 1598392391 | Brett Douglas Foster | Student in an Organized Health Care Education/Training Program | 12 Garret St, Dayton, OH 45410-1226 | 2020-03-24 |
| 1538706940 | Anthony Kelemen | Student in an Organized Health Care Education/Training Program | Sopp At Wright State University, 117 Health Sci Bldg, 3640 Colonel Glenn Hwy, Dayton, OH 45435 | 2019-12-04 |
| 1275184764 | Rachel Wininger | Student in an Organized Health Care Education/Training Program | 117 Health Sciences Building 3640 Colonel Glenn Highway, Dayton, OH 45435-0001 | 2019-09-25 |
| 1801444955 | Ashley Elizabeth Murphy | Student in an Organized Health Care Education/Training Program | Wsu School of Professional Psychology, 3640 Colonel Glenn Hwy, 117 Health Sciences Bldg, Dayton, OH 45435 | 2019-09-02 |
| 1245888304 | Melissa Irene Schmerr | Student in an Organized Health Care Education/Training Program | School of Professional Psychology Wright State Universi, 117 Health Science Bldg. 3640 Colonel Glenn Hwy., Dayton, OH 45435-0001 | 2019-08-30 |
| 1427510510 | Michael S Hatesohl | Student in an Organized Health Care Education/Training Program | 627 South Edwin C. Moses Blvd., East Medical Plaza, 1st Floor, Dayton, OH 45417 | 2019-04-05 |
| Find all providers in DAYTON | ||||
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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.