ETERN S PARK (NPI# 1124289905) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124289905 |
| Entity Type | Individual |
| Full Name | ETERN S PARK |
| Credential | DDS, MD |
| Practice Address |
501 West 14th Street Suite 2w44, Wilmington Hospital Wilmington DE 19801-2200 |
| Mailing Address |
501 W 14th St Ste 2w44 Wilmington DE 19801-1013 |
| Practice Telephone | 3023205730 |
| Mailing Telephone | 3023205730 |
| Enumeration Date | 2008-06-24 |
| Last Update Date | 2018-12-10 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 1223S0112X |
Dentist Specialization: Oral and Maxillofacial Surgery |
C1-0011804 | DE | Dental Providers |
| N | 1223S0112X |
Dentist Specialization: Oral and Maxillofacial Surgery |
G3-0000458 | DE | Dental Providers |
| Y | 1223S0112X |
Dentist Specialization: Oral and Maxillofacial Surgery |
053210 | NY | Dental Providers |
| N | 204E00000X | Oral & Maxillofacial Surgery | 269333 | NY | Allopathic & Osteopathic Physicians |
| Street Address |
501 WEST 14TH STREET SUITE 2W44, WILMINGTON HOSPITAL |
| City | WILMINGTON |
| State | DE |
| Zip Code | 19801-2200 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396715736 | Christiana Care Health Services Inc. | Internal Medicine | 501 West 14th Street, Wilmington, DE 19899 | 2006-01-26 |
| 1902301591 | Zoya Iqbaluddin | Student in an Organized Health Care Education/Training Program | 501 West 14th Street, Wilmington, DE 19899 | 2018-03-27 |
| 1821592197 | Andrew Christopher Young | Student in an Organized Health Care Education/Training Program | 501 West 14th Street, Wilmington, DE 19899 | 2018-03-21 |
| 1437547668 | Stephanie A Evans-mitchell | Nurse Practitioner | 501 West 14th Street, 3rd Floor, Wilmington, DE 19801-1012 | 2014-12-22 |
| 1548664592 | Molly Ann Bergamo | Registered Nurse | 501 West 14th Street, 3rd Floor, Wilmington, DE 19801-1012 | 2014-10-20 |
| 1215362421 | Julia Jordan | Nurse Practitioner | 501 West 14th Street, 3rd Floor, Wilmington, DE 19801-1013 | 2013-09-06 |
| 1609163971 | Vishesh Agarwal | Psychiatry & Neurology | 501 West 14th Street, Wilmington Hospital, 3rd Floor, Wilmington, DE 19801-1012 | 2011-07-07 |
| 1902126147 | Aaron Daniel Broderick | Dentist | 501 West 14th Street, Wilmington, DE 19899 | 2010-06-10 |
| 1346383486 | Amro H. Shihabi | Oral & Maxillofacial Surgery | 501 West 14th Street, Dept. of Oral & Maxillofacial Surgery, Wilmington, DE 19899 | 2007-02-15 |
| 1790848331 | Lynsey Ellen Brandt | Internal Medicine | 501 West 14th Street, Second Floor Health Center, Wilmington, DE 19801-1013 | 2006-12-18 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386126068 | Meghan Cullen | Specialist/Technologist | 401 Garasches Lane, Wilmington, DE 19801 | 2018-08-30 |
| 1497257851 | Jevs Human Services | Psychologist | 300 Delaware Avenue, Suite 210, Wilmington, DE 19801 | 2018-03-01 |
| 1134627144 | Limen House, Inc | Substance Abuse Rehabilitation Facility | 1104 N. Adams Street / Triad, Wilmington, DE 19801 | 2018-01-24 |
| 1538698980 | Triad Ministry Inc | Community/Behavioral Health | 1104 N. Adams Street, Wilmington, DE 19801 | 2017-06-08 |
| 1649706086 | Fhr -act Program | Health Maintenance Organization | 103a Rogers Rd., Wilmington, DE 19801 | 2017-05-04 |
| 1275080707 | Suzanne Isenberg | Social Worker | 103 Rogers Roaad, Wilmington, DE 19801 | 2016-09-01 |
| 1467815191 | Jenna Leigh Laughlin | Internal Medicine | 501 W 14th St., Wilmington, DE 19801 | 2016-03-31 |
| 1962830430 | Antoinette L. Rodriguez | Counselor | 500 W 10th St., Connections Community Support Programs Inc., Wilmington, DE 19801 | 2013-10-21 |
| 1104173509 | Connections Community Support Programs, Inc. | Clinic/Center | 500 W. 10th Street, Wilmington, DE 19801 | 2012-08-06 |
| 1366719916 | Richard Mclaughlin | Counselor | 109 W. 7th St, Crossroads of Delaware, Wilmington, DE 19801 | 2011-11-28 |
| Find all providers in zip 19801 | ||||
| Taxonomy Code | 1223S0112X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Oral and Maxillofacial Surgery |
| The specialty of dentistry which includes the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689224495 | Graham H. Wilson, Dds, Pa | Dentist | 7971 Market Street, Wilmington, NC 28411-9383 | 2019-09-13 |
| 1912200031 | John E Hickory | Dentist | 412 Ann St, Wilmington, NC 28401-4662 | 2010-12-11 |
| 1184941189 | Conrad, Arne', Lombardo, & Krupa, D.d.s, P.a. | Dentist | 7971 Market St, Wilmington, NC 28411-9383 | 2010-04-29 |
| 1689998304 | Gregg A. Lombardo, D.d.s., P.a. | Dentist | 1510 Medical Center Drive, Wilmington, NC 28401-7506 | 2010-03-24 |
| 1437321296 | Brady J. Semmel, Dmd, Md, Pa | Dentist | 1422 Commonwealth Drive, Wilmington, NC 28403-0302 | 2008-04-01 |
| 1811174352 | Douglas F. Degroote, Dds | Dentist | 2250 Shipyard Blvd Ste 15, Wilmington, NC 28403-8070 | 2008-01-28 |
| 1801001516 | David Dieu | Dentist | 1202 Foulk Road, Wilmington, DE 19803 | 2007-05-14 |
| 1043437825 | Michael Lee Hasson | Dentist | 1221 Floral Pkwy Ste 101, Wilmington, NC 28403-6235 | 2007-04-20 |
| 1306971882 | Shawn Conrad | Dentist | 1510 Medical Center Dr, Wilmington, NC 28401-7506 | 2007-02-23 |
| 1770639171 | Michael S. Booth | Dentist | 1305 Physicians Dr., Wilmington, NC 28401-7352 | 2007-01-26 |
| Find all providers in WILMINGTON | ||||
| City | WILMINGTON |
| Zip Code | 19801 |
Please comment or provide details below to improve the information on ETERN S PARK.
| 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.