MEDICARE: DR. KEVIN PARK DDS

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	122300000X	Dentist	31403	TX
2	122300000X	Dentist	103301	CA

General Provider Information

NPI Number	:	1295102317
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KEVIN PARK DDS

Provider Business Mailing Address
First Line	:	104 W 7TH ST
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90014-1906
Country	:	US
Telephone Number	:	626-215-5810
Fax Number	:

Provider Business Practice Location Address
First Line	:	104 W 7TH ST
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90014-1906
Country	:	US
Telephone Number	:	626-215-5810
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/24/2015
Last Update Date	:	06/29/2021

Similar Medicare Providers

1760058929 — KEVIN PARK, DDS, INC.
Practice Location Address:

104 W 7TH ST
LOS ANGELES, CA
90014-1906

Practice Phone: 626-215-5810
Practice Fax:

1528861812 — ZENITH SMILES SERIES 3,LLC
Practice Location Address:

104 W 7TH ST STE 2
LOS ANGELES, CA
90014-1906

Practice Phone: 213-688-2828
Practice Fax:

1154433217 — DR. LINDA L FOSTER O.D.
Practice Location Address:

4921 EAGLE ROCK BLVD
LOS ANGELES, CA
90041-1906

Practice Phone: 323-255-2221
Practice Fax:

1912086331 — DR. YUNGAE KRISTY KIM M.D.
Practice Location Address:

3435 WILSHIRE BLVD STE 500
LOS ANGELES, CA
90010-1906

Practice Phone: 213-384-3435
Practice Fax: 213-384-5559

1588800163 — MISS MEGAN AILEEN DOYLE M.S.W.
Practice Location Address:

8600 W OLYMPIC BLVD
LOS ANGELES, CA
90035-1906

Practice Phone: 714-883-7618
Practice Fax:

1811135049 — MASS TRANSPORTATION SERVICES, INC
Practice Location Address:

6915 LA TIJERA BLVD STE B
LOS ANGELES, CA
90045-1906

Practice Phone: 310-337-1579
Practice Fax:

Directions to “ DR. KEVIN PARK DDS” 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.