DR. MARK PARK (NPI# 1912248683) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1912248683 |
| Entity Type | Individual |
| Full Name | DR. MARK PARK |
| Credential | DMD, MD |
| Practice Address |
260 Old Hook Rd Ste 202 Westwood NJ 07675-3123 |
| Practice Telephone | 3479488622 |
| Enumeration Date | 2013-03-06 |
| Last Update Date | 2019-10-11 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 204E00000X | Oral & Maxillofacial Surgery | 300173 | NY | Allopathic & Osteopathic Physicians |
| N | 204E00000X | Oral & Maxillofacial Surgery | 060757 | NY | Allopathic & Osteopathic Physicians |
| Y | 204E00000X | Oral & Maxillofacial Surgery | 22DI02564200 | NJ | Allopathic & Osteopathic Physicians |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 180 Fort Washington Ave, New York, NY 100323722 | 2123056100 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134734353 | Mark Park | Dentist | 404 Shatto Pl Apt 443, Los Angeles, CA 90020-1739 | 2020-09-14 |
| 1720049034 | Mark C. Park | Optometrist | 6345 Balboa Blvd, Building 3, Suite 250, Encino, CA 91316-1519 | 2006-03-28 |
| 1073517801 | Mark J Park | Optometrist | 919 13th Ave, Delano, CA 93215-2202 | 2005-06-09 |
| Street Address |
260 OLD HOOK RD STE 202 |
| City | WESTWOOD |
| State | NJ |
| Zip Code | 07675-3123 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568008340 | Twinkle Little Star Pediatric Dentistry, LLC | Dentist | 259 Kinderkamack Road, Westwood, NJ 07675 | 2019-11-27 |
| 1245896364 | Edward Feins Dmd, Pa | Dentist | 241 Rivervale Road, River Vale, NJ 07675 | 2019-05-14 |
| 1134699200 | Angelly Guzman | Social Worker | 192 3rd Ave., Westwood, NJ 07675 | 2018-11-30 |
| 1477091270 | Sports Medicine Center of Bergen, Pa | Physical Therapist | 216 Old Tappan Road, Suite 56-58d, Old Tappan, NJ 07675 | 2017-02-01 |
| 1871965392 | Jesse Glassman | Psychologist | 354 Old Hook Rd. Suite 203, Westwood, NJ 07675 | 2015-10-23 |
| 1972981249 | Sabrina Tate Hegarty | Physical Therapist | 38 Adams Court, Westwood, NJ 07675 | 2015-05-07 |
| 1205220910 | Annamma Goerge | Nurse Practitioner | 333 Old Hook Road, Suite 103, Endocrinology and Diabetes Associates, LLC, Westwood, NJ 07675 | 2015-03-20 |
| 1871997833 | Tia Davis | Social Worker | 80 Westwood Blvd, Westwood, NJ 07675 | 2014-10-20 |
| 1336564400 | Jessica Digiacomo | Counselor | 192 Third Avenue, Suite 1-b, Westwood, NJ 07675 | 2014-02-26 |
| 1487078507 | Bergen Pediatric Speech Therapy | Speech-Language Pathologist | 354 Old Hook Rd., Ll-1, Westwood, NJ 07675 | 2014-02-10 |
| Find all providers in zip 07675 | ||||
| Taxonomy Code | 204E00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Oral & Maxillofacial Surgery |
| Oral and maxillofacial surgeons are trained to recognize and treat a wide spectrum of diseases, injuries and defects in the head, neck, face, jaws and the hard and soft tissues of the oral and maxillofacial region. They are also trained to administer anesthesia, and provide care in an office setting. They are trained to treat problems such as the extraction of wisdom teeth, misaligned jaws, tumors and cysts of the jaw and mouth, and to perform dental implant surgery. |
| Notes: Source: American College of Surgeons, 2013. www.facs.org [7/1/2013: definition added, source added, additional resources added] Additional Resources: American Board of Oral and Maxillofacial Surgery and American Association of Oral and Maxillofacial Surgeons While this is generally considered a specialty of dentistry, physicians can also be board certified as oral and maxillofacial surgeons through the American Board of Oral and Maxillofacial Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659923969 | Sunhee Lee Dmd Pa | Oral & Maxillofacial Surgery | 1 Dewolf Rd Ste 102, Old Tappan, NJ 07675-7084 | 2019-07-16 |
| 1336630599 | Steven Frank Bogart Dds and Hubert Gugala Dmd | Oral & Maxillofacial Surgery | 57 Route 46 Suite 207, Hackettstown, NJ 07860 | 2018-05-23 |
| 1760910046 | Southern Ocean Osic, Inc | Oral & Maxillofacial Surgery | 1322 Route 72 W Ste 204, Manahawkin, NJ 08050-2486 | 2017-05-31 |
| 1245697432 | Middletown Oral Surgery Associates, P.C. | Oral & Maxillofacial Surgery | 21 New Monmouth Road, Middletown, NJ 07748 | 2016-01-20 |
| 1992118087 | Lanoka Shores LLC | Oral & Maxillofacial Surgery | 249 S Main St Unit 4, Barnegat, NJ 08005-2301 | 2014-06-05 |
| 1316382641 | Nikolay Levintov | Oral & Maxillofacial Surgery | C3 Cornwall Dr, East Brunswick, NJ 08816 | 2013-04-30 |
| 1457417495 | Oral & Maxillofacial Assoc of Nutley | Oral & Maxillofacial Surgery | 187 Washington Avenue, Suite 1b, Nutley, NJ 07110 | 2006-12-27 |
| 1336216795 | Joseph D Dmaio | Oral & Maxillofacial Surgery | 590 Westfield Ave, Westfield, NJ 07090 | 2006-11-29 |
| 1508930678 | David Z Evdokimow | Oral & Maxillofacial Surgery | 96 S Finley Ave, Basking Ridge, NJ 07920-1422 | 2006-11-20 |
| 1306955042 | Maurice M Maccario | Oral & Maxillofacial Surgery | 180 Ramapo Valley Road, Oakland, NJ 07436 | 2006-08-29 |
| 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.