Ethan Park Dmd Inc
LBN: Ethan Park Dmd Inc
Ethan Park Dmd Inc is an health care organization with primary practice located at 5728 Rosemead Blvd Suite 220 , Temple City CA 91780-1814. The organization recently has 2 registered licenses in different health care specialties including Dental Providers / General Practice, Ambulatory Health Care Facilities / Dental. Dental Providers / General Practice is the primary health care specialty.
Ethan Park Dmd Inc can be contacted via phone (626) 500-4340, or through Park, Ethan Sb via phone (213) 220-4856.
Contact Information
Primary practice address
5728 Rosemead Blvd Suite 220
Temple City CA 91780-1814
Phone: (626) 500-4340
Fax: (626) 544-5335
Website:
Authorized official contact:
Name: Park, Ethan Sb Doctor of Dental Surgery (DDS)
Phone: (213) 220-4856
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / General Practice | 1223G0001X | ||
| Ambulatory Health Care Facilities / Dental | 261QD0000X |
Profile Details
| NPI number | 1275117491 |
|---|---|
| LBN Legal business name | Ethan Park Dmd Inc |
| DBA Doing business as | |
| Authorized official | Park, Ethan Sb Doctor of Dental Surgery (DDS) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | May 12th, 2021 |
| Last updated | Jul 13th, 2023 - about 2 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1275117491 | NPPES |
| California | Other | 100873 | DENTIST |
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