MEDICARE: D PARK MPH DENTAL, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry

General Provider Information

NPI Number	:	1508462649
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	D PARK MPH DENTAL, INC.

Provider Business Mailing Address
First Line	:	12021 S. WILMINGTON AVE STE 1100
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90059-3019
Country	:	US
Telephone Number	:	888-585-3368
Fax Number	:	661-471-2121

Provider Business Practice Location Address
First Line	:	12021 S. WILMINGTON AVE STE 1100
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90059-3019
Country	:	US
Telephone Number	:	888-585-3368
Fax Number	:	661-471-2121

Authorized Official
Title or Position	:	DENTIST
Name	:	DAVID S PARK
Credential	:
Telephone Number	:	310-403-1117

Provider Enumeration Date	:	12/04/2020
Last Update Date	:	05/12/2021

Similar Medicare Providers

1003531641 — NATALIA MALDONADO
Practice Location Address:

12021 WILMINGTON AVE STE 2B
LOS ANGELES, CA
90059-3019

Practice Phone: 213-222-1681
Practice Fax:

1720521057 — MR. ALEXIS GOMEZ
Practice Location Address:

12021 WILMINGTON AVE UNIT 2B
LOS ANGELES, CA
90059-3019

Practice Phone: 213-222-1681
Practice Fax:

1962043968 — KASHMIER IRVAE MORALES
Practice Location Address:

12021 WILMINGTON AVE
LOS ANGELES, CA
90059-3019

Practice Phone: 424-454-6027
Practice Fax:

1881225910 — MR. AARON ANDREW STREET B.A.
Practice Location Address:

12021 WILMINGTON AVE STE 2B
LOS ANGELES, CA
90059-3019

Practice Phone: 213-222-1681
Practice Fax:

1063142941 — CAROLINA CHAVEZ
Practice Location Address:

12021 WILMINGTON AVE
LOS ANGELES, CA
90059-3019

Practice Phone: 310-668-3484
Practice Fax:

1578173290 — DEVIN GREEN LCSW
Practice Location Address:

12021 WILMINGTON AVE
LOS ANGELES, CA
90059-3019

Practice Phone: 213-503-5167
Practice Fax:

1245180249 — ROSA CLARA CONTRERAS ASW
Practice Location Address:

12021 WILMINGTON AVE , BLDG 18, 4TH FLR SUITE 4D
LOS ANGELES, CA
90059-3019

Practice Phone: 323-743-7902
Practice Fax:

Directions to “D PARK MPH DENTAL, INC. ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.