DR. DAVID A PARK (NPI# 1750404786) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1750404786 |
| Entity Type | Individual |
| Full Name | DR. DAVID A PARK |
| Credential | M.D., D.D.S. |
| Practice Address |
3610 N University Ave Suite 150 Provo UT 84604-4437 |
| Practice Telephone | 8013562226 |
| Practice Fax Number | 8018121734 |
| Mailing Telephone | 8013562226 |
| Mailing Fax Number | 8018121734 |
| Enumeration Date | 2007-04-06 |
| Last Update Date | 2008-07-28 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223S0112X |
Dentist Specialization: Oral and Maxillofacial Surgery |
5129759 | UT | Dental Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013524743 | David Park | Dentist | 810 3rd Ave Ste 200, Seattle, WA 98104-1614 | 2020-09-27 |
| 1447879648 | David Jaehyun Park | Student in an Organized Health Care Education/Training Program | 193 Oak St Apt 202e, Newton Upper Falls, MA 02464-1449 | 2020-04-09 |
| 1093363574 | David Mansug Park | Acupuncturist | 5200 Newberry Rd Ste D8, Gainesville, FL 32607-2177 | 2019-08-28 |
| 1831614387 | David Ji Hyun Park | Dentist | 393 Dunlap St N Ste 308, Saint Paul, MN 55104-4223 | 2017-08-06 |
| 1265686448 | David H Park | Dentist | 3530 Dartmouth Ln, Rowland Heights, CA 91748-5135 | 2008-11-14 |
| 1578763413 | David Kyung-il Park | Emergency Medicine | 2500 Merced Sreet, San Leandro, CA 94577-4201 | 2007-07-19 |
| 1942410501 | David S Park | Dentist | 10390 Coloma Rd Ste A, Rancho Cordova, CA 95670-2152 | 2007-05-23 |
| 1780762245 | David Hwantae Park | Optometrist | 7750 N Macarthur Blvd, Ste 180, Irving, TX 75063-7524 | 2006-11-01 |
| 1942315874 | David Daegeun Park | Family Medicine | 119 S Fuquay Avenue, Fuquay-varina, NC 27526-2210 | 2006-08-20 |
| 1114558897 | David Seho Park | Pharmacist | 25825 Vermont Ave, Harbor City, CA 90710-3518 | 2020-01-30 |
| Street Address |
3610 N UNIVERSITY AVE SUITE 150 |
| City | PROVO |
| State | UT |
| Zip Code | 84604-4437 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477693802 | Blake Lynn Matthews | Dentist | 3610 N University Ave, #200, Provo, UT 84604-4437 | 2007-02-07 |
| 1659534485 | Jeffrey L Trapnell | Dentist | 3610 N University Ave, Suite #175, Provo, UT 84604-4437 | 2008-07-02 |
| 1275722357 | Utah Surgical Arts | Clinic/Center | 3610 N University Ave, Suite 150, Provo, UT 84604-4437 | 2007-10-15 |
| 1669595765 | Michael D Harris | Dentist | 3610 N University Ave, Suite 150, Provo, UT 84604-4437 | 2007-04-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346882107 | Abigail Belle Hardy | Student in an Organized Health Care Education/Training Program | 1190 900 E, Provo, UT 84604 | 2019-10-14 |
| 1386106698 | Sarah Roseman Hunt | Nurse Practitioner | 1055 N 500 W., Suite. 101, Bldg. C, Provo, UT 84604 | 2019-04-04 |
| 1255813325 | Hwigeum Jeong | Specialist/Technologist | Department of Exercise Sciences 106 Sfh Brigham Young, Provo, UT 84604 | 2018-09-05 |
| 1093203044 | Snowcap Smile Studio LLC | Dentist | 2230 N. University Pkwy Ste 8b, Provo, UT 84604 | 2018-04-25 |
| 1407359078 | Ihc Health Services Inc | Clinic/Center | 380 W Bulldog Blvd, Ste 403, Provo, UT 84604 | 2018-03-09 |
| 1902308455 | Afton Leuga | Nurse Practitioner | 395 W Bulldog Blvd., Suite 401, Provo, UT 84604 | 2018-03-01 |
| 1851807333 | Ihc Health Services Inc | Family Medicine | 380 W 1230 N, Ste 602, Provo, UT 84604 | 2017-12-20 |
| 1689180218 | Ihc Health Services Inc | Pediatrics | 395 W Bulldog Blvd Ste 703, Provo, UT 84604 | 2017-12-19 |
| 1396254165 | Nicolas Sorensen | Massage Therapist | 247 West 2230 North #201, Provo, UT 84604 | 2017-09-25 |
| 1437692241 | Cirque Lodge Inc | Substance Abuse Rehabilitation Facility | 3114 E Ida's Road, Sundance, UT 84604 | 2016-11-28 |
| Find all providers in zip 84604 | ||||
| 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 |
|---|---|---|---|---|
| 1346629441 | Eric Wood | Dentist | 3610 N University Ave Ste 150, Provo, UT 84604-4444 | 2015-05-21 |
| 1669595765 | Michael D Harris | Dentist | 3610 N University Ave, Suite 150, Provo, UT 84604-4437 | 2007-04-06 |
| 1649353715 | Gary Lyle Crawford | Dentist | 777 N 500 W, Provo, UT 84601-1541 | 2006-10-23 |
| 1093898157 | William Lecile Mcbee | Dentist | 777 N 500 W, Suite 102, Provo, UT 84601-1541 | 2006-10-23 |
| 1497838577 | Oral Maxillofacial Surgery Pllc | Dentist | 777 N 500 W, Suite 102, Provo, UT 84601-1541 | 2006-10-23 |
| 1578646642 | Niles Walter Herrod | Dentist | 777 N 500 W, Suite 102, Provo, UT 84601-1541 | 2006-10-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891394631 | Vineyard Oral and Maxillofacial Surgery | Dentist | 707 E Mill Rd Ste 102, Vineyard, UT 84059-5732 | 2020-10-22 |
| 1306489059 | Alpine Dentists and Specialists Pllc | Dentist | 20 W Main Street Ct Ste 100, Alpine, UT 84004-1889 | 2019-10-25 |
| 1194213074 | Lehi Oral Surgery PC | Dentist | 2961 W Maple Loop Dr Ste 130, Lehi, UT 84043-5717 | 2018-04-26 |
| 1568974434 | Utah Wisdom Teeth, LLC | Dentist | 1030 E 11400 S Ste 2a, Sandy, UT 84094-6906 | 2017-10-31 |
| 1447623830 | Great Smiles Dental Clinic LLC | Dentist | 7410 S Creek Rd, #303, Sandy, UT 84093-6140 | 2015-11-06 |
| 1679943831 | Creekside Oral & Facial Surgery Inc | Dentist | 7390 S Creek Rd, Suite 101, Sandy, UT 84093-6119 | 2015-09-30 |
| 1023336104 | Adam C Stanley | Dentist | 3632 W South Jordan Pkwy Ste 103, South Jordan, UT 84009-7163 | 2010-05-13 |
| 1790012243 | Southern Utah Surgical Arts | Dentist | 393 E Riverside Dr Bldg 2, Suite 2b, St George, UT 84790-7065 | 2009-11-04 |
| 1487887204 | Joseph Fullmer | Dentist | 493 S Main St # 200, Heber City, UT 84032-2240 | 2009-08-27 |
| 1407085160 | Davis Center for Oral & Maxillofacial Surgery | Dentist | 890 Heritage Park Blvd Ste 103, Layton, UT 84041-5622 | 2009-07-02 |
| 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.