SUSAN PARK (NPI# 1104230838) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104230838 |
| Entity Type | Individual |
| Full Name | SUSAN PARK |
| Credential | D.D.S. |
| Practice Address |
3607 Old Spanish Trl Suite G Houston TX 77021 |
| Mailing Address |
3607 Old Spanish Trl Suite G Houston TX 77021-2312 |
| Practice Telephone | 2817479500 |
| Mailing Telephone | 2817479500 |
| Enumeration Date | 2014-06-20 |
| Last Update Date | 2016-11-02 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 122300000X | Dentist | 63372 | CA | Dental Providers |
| Y | 1223G0001X |
Dentist Specialization: General Practice |
32105 | TX | Dental Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598117012 | Susan S Park | Pharmacist | 15131 E Crestline Ave, Centennial, CO 80015-2517 | 2016-07-08 |
| 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 |
| 1811159411 | Susan Kyung Park | Student in an Organized Health Care Education/Training Program | 14445 Olive View Drive, Sylmar, CA 91342 | 2008-06-26 |
| Street Address |
3607 OLD SPANISH TRL SUITE G |
| City | HOUSTON |
| State | TX |
| Zip Code | 77021 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386003275 | South Houston Mint Dentistry, Pllc | Clinic/Center | 3607 Old Spanish Trl, Houston, TX 77021-2312 | 2016-02-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700409331 | Chinyere Eigege | Social Worker | 5334 Keystone St, Houston, TX 77021 | 2020-05-18 |
| 1821625815 | Essential Body Bar, Pllc | Nurse Practitioner | 5751 Blythwood Street, Suite 200, Houston, TX 77021 | 2020-03-27 |
| 1699311944 | Devoted Angels LLC | Meals | 7807 Tierwester Street, Houston, TX 77021 | 2019-11-21 |
| 1013495696 | Ethel Row, LLC | Counselor | 1 Hermann Park Court, Unit 645, Houston, TX 77021 | 2018-08-05 |
| 1023594504 | Daniel Todd Jankowski | Dentist | 6102 Scott St, Houston, TX 77021 | 2018-07-17 |
| 1861988164 | Houston Area Community Services, Inc | Clinic/Center | 4405 Griggs Road, Houston, TX 77021 | 2018-07-10 |
| 1942739123 | Optimcurea LLC | Internal Medicine | 2440 D Charleston Street, Houston, TX 77021 | 2017-06-09 |
| 1699229138 | Angela Dobbins | Psychologist | 5400 Griggs Rd Ste 101, Houston, TX 77021 | 2016-08-13 |
| 1194180877 | Alina Leigh | Nurse Practitioner | 5737 Cullen Suite 200, Houston, TX 77021 | 2015-12-22 |
| 1336514751 | Joshua In Home Quality Health Care | In Home Supportive Care | 3822 Southlawn Street, 3, Houston, TX 77021 | 2015-12-10 |
| Find all providers in zip 77021 | ||||
| Taxonomy Code | 1223G0001X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | General Practice |
| A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. |
| Notes: Source: Academy of General Dentistry |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386242923 | Exquisite Dental Smiles Pllc | Dentist | 2200 Aldine Mail Route Rd # 106, Houston, TX 77039 | 2020-10-15 |
| 1568069094 | Vintage Smile Family Dentistry | Dentist | 10300 Louetta Rd, Houston, TX 77070-2121 | 2020-10-07 |
| 1093322836 | Lan Hoang Dao | Dentist | 6711 Mission Bell Dr, Houston, TX 77083-2524 | 2020-09-25 |
| 1871107714 | Nbnl Dental Pllc | Dentist | 4400 North Fwy Spc C300, Houston, TX 77022-3649 | 2020-09-08 |
| 1780293613 | Namrata Rathod | Dentist | 1255 Eldridge Pkwy Apt 126, Houston, TX 77077-2161 | 2020-07-27 |
| 1104434752 | Pavana Kulathanal Chakrapani | Dentist | 1072 Federal Rd, Houston, TX 77015-4804 | 2020-07-20 |
| 1821606039 | Po-lin Yang | Dentist | 4500 Washington Ave Ste 700, Houston, TX 77007-5478 | 2020-07-14 |
| 1053939637 | Anusha Joseph | Dentist | 306 Woodcombe Dr, Houston, TX 77062-2540 | 2020-07-09 |
| 1508482860 | Garcia- Alcover Dental Pllc | Dentist | 6720 Chimney Rock Rd Ste S, Houston, TX 77081-5640 | 2020-06-23 |
| 1205452893 | Linh Ngoc Pham | Dentist | 9207 Meadow Branch Ct, Houston, TX 77095-2753 | 2020-06-19 |
| Find all providers in HOUSTON | ||||
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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.