OLIVIA JIN-YOUNG PARK (NPI# 1982952198) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1982952198 |
| Entity Type | Individual |
| Full Name | OLIVIA JIN-YOUNG PARK |
| Credential | D.D.S. |
| Practice Address |
1110 E Lerdo Hwy # 200 Shafter CA 93263-9415 |
| Practice Telephone | (661) 746-6989 |
| Mailing Telephone | (661) 746-6989 |
| Enumeration Date | 2012-08-20 |
| Last Update Date | 2018-03-17 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 122300000X | Dentist | 61769 | CA | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | CALIFORNIA DENTAL BOARD | 61769 | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 4401 Ming Ave, Bakersfield, CA 933094817 | 6613977400 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881219939 | Olivia Park | Student in an Organized Health Care Education/Training Program | 150 Harbour Way, Richmond, CA 94801-3554 | 2020-06-15 |
| 1710538186 | Olivia Park | Pharmacist | 4223 162nd St, Flushing, NY 11358-4152 | 2019-09-26 |
| 1588037105 | Olivia Park | Pharmacist | 49980 Jefferson St, Indio, CA 92201-9720 | 2015-11-04 |
| 1669761748 | Olivia Park | Physical Medicine & Rehabilitation | W180n8085 Town Hall Rd, Menomonee Falls, WI 53051-3518 | 2011-03-29 |
| Street Address |
1110 E LERDO HWY # 200 |
| City | SHAFTER |
| State | CA |
| Zip Code | 93263-9415 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265958235 | Danessa Thorbrogger | Nurse Practitioner | 565 Kern Street, Shafter, CA 93263 | 2017-08-21 |
| 1376994533 | Shafter Urgent Care | Clinic/Center | 501 Munzer St Ste A, Shafter, CA 93263 | 2016-06-28 |
| 1821442658 | Huy Xuan Dang | Pharmacist | 825 Central Valley Hwy Ste A, Shafter, CA 93263 | 2016-04-18 |
| 1811362908 | Shafter Pediatrics | Pediatrics | 501 Munzer St, Suite C, Shafter, CA 93263 | 2015-12-01 |
| 1174769616 | Parrott Gordon & Associates L.p. | Dentist | 1110 E. Lerdo Highway, 200, Shafter, CA 93263 | 2009-01-06 |
| 1164696449 | Michael Komin Md Medical Corportion | Preferred Provider Organization | 1150 E Lerdo Hwy #c, Shafter, CA 93263 | 2008-04-17 |
| 1154526176 | Christine M Armstrong | Counselor | 151 Munzes St, Shefter, CA 93263 | 2007-06-19 |
| 1336327154 | Omni Family Health | Clinical Medical Laboratory | 659 S Central Valley Hwy, Shafter, CA 93263 | 2008-02-04 |
| 1477677821 | Joel N Cooper Physical Therapist Inc. | Physical Therapist | 142 E Tulare Ave, Shafter, CA 93263-1834 | 2007-03-19 |
| 1023060571 | Ggnsc Shafter Lp | Skilled Nursing Facility | 140 E Tulare Ave, Shafter, CA 93263-1834 | 2006-05-16 |
| Find all providers in zip 93263 | ||||
| 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 |
|---|---|---|---|---|
| 1609086446 | Josephine C. Silverio | Dentist | 655 S Central Valley Hwy, Shafter, CA 93263-2790 | 2007-05-23 |
| 1497807168 | Nasr Mousa Botrous Mousa | Dentist | 659 S Central Valley Hwy, Shafter, CA 93263-2790 | 2007-01-16 |
| 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.