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General NPI Number Information
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NPI Number | 1982223574
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Entity Type | Individual
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Provider Name | DAMIN PARK DMD
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Gender | Male
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Dates
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Enumeration Date | 04/13/2020
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Last Update Date | 08/21/2025
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Provider Practice Location Address
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Address Line | 120 EAST AVE STE 3E
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City | NORWALK
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State | CT
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Zip | 06851-5786
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Country | US
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Telephone | 203-635-6300
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Fax |
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Provider Business Mailing Address
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Address Line | 120 EAST AVE STE 3E
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City | NORWALK
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State | CT
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Zip | 06851-5786
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | DN1859113
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License Number State | MA
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Taxonomy #2
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Taxonomy Code | 204E00000X
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Taxonomy Name | Oral & Maxillofacial Surgery (D.M.D.)
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License Number | DR61069032
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License Number State | WA
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Taxonomy #3
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State | WA
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Taxonomy #4
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Taxonomy Code | 1223E0200X
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Taxonomy Name | Endodontics
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License Number | 13953
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License Number State | CT
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