Dennis J Park, DDS
Dentist, General Practice in Kennewick, WA. Individual provider (NPI-1).
NPI number1649313263
StatusActive
Last updated in NPPESJul 8, 2007
Details
- NPI
- 1649313263
- Entity type
- Individual (NPI-1)
- Name
- Dennis J Park
- Credential
- DDS
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Feb 14, 2007
- Last updated
- Jul 8, 2007
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1223G0001X | Dentist, General Practice | DE00005469 | WA | Yes |
Practice location
1310 N Grant StKennewick, WA 99336-1355
Phone 509-783-7275
Mailing address
1310 N Grant StKennewick, WA 99336-1355
Phone 509-783-7275
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This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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