SAM S PARK (NPI# 1831614213) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1831614213 |
| Entity Type | Individual |
| Full Name | SAM S PARK |
| Credential | DMD |
| Practice Address |
1222 Magnolia Ave Ste 101 Corona CA 92881-2075 |
| Mailing Address |
5555 Crestridge Rd Apt 210 Rancho Palos Verdes CA 90275-3580 |
| Practice Telephone | 9092560456 |
| Mailing Telephone | 3103448893 |
| Enumeration Date | 2017-08-07 |
| Last Update Date | 2018-03-17 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 122300000X | Dentist | DDS101611 | CA | Dental Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 514 E Washington Blvd, Los Angeles, CA 900153723 | 2137493934 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295871267 | Sam Park | Dentist | 2959 S Wallace St, Children's Dental World, Chicago, IL 60616-3034 | 2007-01-29 |
| Street Address |
1222 MAGNOLIA AVE STE 101 |
| City | CORONA |
| State | CA |
| Zip Code | 92881-2075 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326682519 | Kadour and Hattar Inc | Pharmacy | 1973 Foothill Pkwy, Bldg F, Ste 106, Corona, CA 92881 | 2019-10-31 |
| 1861034944 | Jongguon Kim Dds Dental Corporation | Clinic/Center | 1973 Foothill Parkway, Suite 102, Corona, CA 92881 | 2019-10-10 |
| 1952874968 | Sasha M Dunn | Behavior Technician | 2144 Wembley Lane, Corona, Corona, CA 92881 | 2019-01-03 |
| 1053880450 | Tori Bissett Bowyer | Behavioral Analyst | 3439 White Sage St, Corona, CA 92881 | 2018-11-15 |
| 1104351097 | Victoria S. Brown | Family Medicine | 2071 Compton Ave #103, Corona, CA 92881 | 2017-04-27 |
| 1740695493 | Zoha Fazel | Counselor | 1240 E Ontario Ave Ste 102-182, Corona, CA 92881 | 2014-06-20 |
| 1720347222 | Neda Arjomandi | Podiatrist | 1881 California Ave Ste 102, Corona, CA 92881 | 2012-05-03 |
| 1891067864 | Valley Laparoscopic Surgical Associates, Inc. | Specialist | 2083 Compton Ave Ste 104, Corona, CA 92881 | 2012-02-06 |
| 1922396191 | Michelle Ann Mueller | Dietitian, Registered | 1800 Firethorne Plance, Apt. 108, Corona, CA 92881 | 2011-07-21 |
| 1558668772 | Jenna Lalas Eugenio | Physician Assistant | 2097 Compton Ave Ste 103, Corona, CA 92881 | 2011-02-24 |
| Find all providers in zip 92881 | ||||
| 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 |
|---|---|---|---|---|
| 1063011799 | Jordan Chelsey Douglas | Dentist | 460 N Mckinley St, Corona, CA 92879-3405 | 2020-10-23 |
| 1003423286 | Radhika Makadia | Dentist | 8387 Butterfly Bush Ct, Corona, CA 92883-4936 | 2020-09-30 |
| 1225646706 | Shweta Jain | Dentist | 3460 Summitpointe Cir, Corona, CA 92881-8354 | 2020-07-21 |
| 1730797614 | Brittany Sharleen Watu | Dentist | 916 W. Sixth Street, Corona, CA 92882-3239 | 2020-07-16 |
| 1144868373 | Jacqueline Astrid Marquez | Dentist | 1312 E Ontario Ave Ste 102, Corona, CA 92881-6645 | 2019-12-18 |
| 1447715743 | J Chun Dental Corp | Dentist | 1112 W 6th St Ste 105, Corona, CA 92882-3137 | 2019-01-31 |
| 1609322155 | Abhishek Joshi Dds,inc. | Dentist | 12738 Longhorne Dr, Corona, CA 92880-8839 | 2016-08-25 |
| 1932559713 | Wonjoon Lee | Dentist | 3283 Quartz Cir, Corona, CA 92882-6096 | 2016-06-13 |
| 1124476254 | Bhavik Bhakta | Dentist | 770 Magnolia Ave Ste 1a, Corona, CA 92879-3121 | 2016-05-31 |
| 1356724645 | Hoa Nguyen | Dentist | 12875 Oakdale St, Corona, CA 92880-8548 | 2015-07-04 |
| Find all providers in CORONA | ||||
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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.