DR. SALLY PARK (NPI# 1417145160) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417145160 |
| Entity Type | Individual |
| Full Name | DR. SALLY PARK |
| Credential | D.D.S., M.S.D. |
| Practice Address |
1500 Alps Rd Wayne NJ 07470-3635 |
| Practice Telephone | 9736965220 |
| Mailing Telephone | 9736965220 |
| Enumeration Date | 2007-10-09 |
| Last Update Date | 2007-10-09 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223X0400X |
Dentist Specialization: Orthodontics and Dentofacial Orthopedics |
22D102133200 | NJ | Dental Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154790665 | Sally Park | Pharmacist | 1606 Barnum Ave, Stratford, CT 06614-5301 | 2015-09-15 |
| Street Address |
1500 ALPS RD |
| City | WAYNE |
| State | NJ |
| Zip Code | 07470-3635 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952398588 | Priya Sivaraman | Family Medicine | 1500 Alps Rd, Wayne, NJ 07470-3635 | 2005-09-29 |
| 1023348687 | Meera V Patel | Family Medicine | 1500 Alps Rd, Wayne, NJ 07470-3635 | 2010-01-05 |
| 1487736294 | David Perry, Jr. | Physician Assistant | 1500 Alps Rd, Wayne, NJ 07470-3635 | 2006-10-20 |
| 1184730277 | Stephanie L Roseti | Nurse Practitioner | 1500 Alps Rd, Wayne, NJ 07470-3635 | 2006-08-22 |
| 1730198995 | Susan M Kirschenbaum | Physician Assistant | 1500 Alps Rd, Wayne, NJ 07470-3635 | 2006-08-05 |
| 1851305155 | Alps Family Physicians Pa | Family Medicine | 1500 Alps Rd, Wayne, NJ 07470-3635 | 2006-07-29 |
| 1174537898 | Francis Jerome-xavier Bain | Family Medicine | 1500 Alps Rd, Wayne, NJ 07470-3635 | 2006-07-28 |
| 1891717294 | James Lampariello | Family Medicine | 1500 Alps Rd, Wayne, NJ 07470-3635 | 2006-07-24 |
| 1760403497 | Anthony M Ventimiglia | Family Medicine | 1500 Alps Rd, Wayne, NJ 07470-3635 | 2006-07-21 |
| 1780616730 | Mark Howard Terry | Dentist | 1500 Alps Rd, Wayne, NJ 07470-3635 | 2006-07-07 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669073086 | Brightview Hamburg, LLC | Alzheimer Center (Dementia Center) | 1139 Hamburg Turnpike, Wayne, NJ 07470 | 2020-11-03 |
| 1912536301 | Stevenson Dominique | Physician Assistant | 1700 Nj-23 # 170, Wayne, NJ 07470 | 2020-04-07 |
| 1710524087 | Engel Burman At Wayne, LLC | Assisted Living Facility | 1440 Hamburg Turnpike, Wayne, NJ 07470 | 2019-12-05 |
| 1508412669 | Jessie Diana Dunitz | Technician | 66 Sandra Lane, Wayne, NJ 07470 | 2019-08-14 |
| 1447737234 | Meza Behavioral Health, Inc. | Psychologist | 40 Edgemont Crescent, Wayne, NJ 07470 | 2018-07-24 |
| 1881188076 | Christine Nolan | Occupational Therapist | 1 Pike Drive, Wayne, NJ 07470 | 2018-06-20 |
| 1033612403 | County of Passaic Department of Finance | Skilled Nursing Facility | 305 Oldham Road, Wayne, NJ 07470 | 2018-03-13 |
| 1144739590 | Broadway Respite and Home Care | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 7 Allen Drive, Wayne, NJ 07470 | 2017-09-28 |
| 1679096697 | Wafaa Saad | Counselor | 1009 Valley Rd, Wayne, NJ 07470 | 2017-07-21 |
| 1659803138 | Allison Nicole Diangelo | Nurse Practitioner | 1578 Rte 23, Wayne, NJ 07470 | 2017-04-03 |
| Find all providers in zip 07470 | ||||
| Taxonomy Code | 1223X0400X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Orthodontics and Dentofacial Orthopedics |
| That area of dentistry concerned with the supervision, guidance and correction of the growing or mature dentofacial structures, including those conditions that require movement of teeth or correction of malrelationships and malformations of their related structures and the adjustment of relationships between and among teeth and facial bones by the application of forces and/or the stimulation and redirection of functional forces within the craniofacial complex. Major responsibilities of orthodontic practice include the diagnosis, prevention, interception and treatment of all forms of malocclusion of the teeth and associated alterations in their surrounding structures; the design, application and control of functional and corrective appliances; and the guidance of the dentition and its supporting structures to attain and maintain optimum occlusal relations in physiologic and esthetic harmony among facial and cranial structures. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932732856 | Elite Orthodontics | Dentist | 61 Berdan Ave, Wayne, NJ 07470-3231 | 2020-02-19 |
| 1528305919 | Muhammad Abey | Dentist | 342 Hamburg Tpke Ste 106, Wayne, NJ 07470-2166 | 2013-01-06 |
| 1861532087 | Elizabeth K Ellen | Dentist | 659 Valley Rd, Wayne, NJ 07470-3529 | 2007-02-07 |
| 1770629511 | Normand S Boucher | Dentist | 333 W Lancaster Ave, Wayne, PA 19087-3904 | 2007-01-29 |
| 1033281852 | James Gillig | Dentist | 38110 Michigan Av, Wayne, MI 48184 | 2006-11-15 |
| 1326645037 | Candid Pennsylvania, LLC | Dentist | 175 Strafford Ave Ste 1, Wayne, PA 19087-3340 | 2020-10-06 |
| 1316301443 | Wayne Orthodontics LLC | Dentist | 401 Hamburg Tpke, Suite 210, Wayne, NJ 07470-2154 | 2016-04-05 |
| 1174934251 | Diamond Braces Wayne | Dentist | 401 Hamburg Tpke, Suite 210, Wayne, NJ 07470-2154 | 2014-05-12 |
| 1225159320 | Elizabeth Ellen Dmd | Dentist | 659 Valley Rd, Wayne, NJ 07470-3529 | 2007-04-03 |
| 1902975378 | Lawrence Alan Piekarsky | Dentist | 150 Hinchman Ave, Wayne, NJ 07470-2360 | 2006-11-07 |
| Find all providers in WAYNE | ||||
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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.