Changsu Park, D D S in Represa, CA - Dentist

Changsu Park, D D S is a Dentist based in Represa, California. Changsu Park is licensed to practice in California (license number 35532) and his current practice location is 100 Prison Rd, Represa, California. He can be reached at his office (for appointments etc.) via phone at (916) 985-8610.

NPI number for Changsu Park is 1548441033 and his current mailing address is Po Box 290002, Represa, California. He does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1548441033.

Contact Information

	Changsu Park, D D S
	100 Prison Rd, Represa, CA 95671-0002
	(916) 985-8610
	Not Available

Healthcare Provider's Profile

Full Name	Changsu Park
Gender	Male
Speciality	Dentist
Location	100 Prison Rd, Represa, California
Accepts Medicare Assignments	Does not participate in Medicare Program. He may not accept medicare assignment.

NPI Data:

NPI Number: 1548441033
Provider Enumeration Date: 11/26/2007
Last Update Date: 03/07/2016

Medical Identifiers

Medical identifiers for Changsu Park such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1548441033	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
122300000X	Dentist	35532 (California)	Primary

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Changsu Park is NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Changsu Park, D D S Po Box 290002, Represa, CA 95671-0002 Ph: (916) 985-8610	Changsu Park, D D S 100 Prison Rd, Represa, CA 95671-0002 Ph: (916) 985-8610

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Dentist in Represa, CA

Dr. John Maciel Jr., DDS Dentist Medicare: Not Enrolled in Medicare Practice Location: 100 Prison Road, California State Prison Sacramento, Represa, CA 95671 Phone: 916-985-8610
Dr. Harry Moran Singh Dhesi, DDS Dentist Medicare: Not Enrolled in Medicare Practice Location: 100 Prison Road, California State Prison Sacramento, Represa, CA 95671 Phone: 916-985-8610
Dr. Jocko Sarabia, D.D.S. Dentist Medicare: Not Enrolled in Medicare Practice Location: 100 Prison Rd, Represa, CA 95671 Phone: 191-698-5861 Fax: 916-294-3194
Dr. Gregory Carl Tinloy, D.D.S. Dentist Medicare: Not Enrolled in Medicare Practice Location: 100 Prison Rd., Represa, CA 95671 Phone: 916-985-8610
Dr. Carl M Griffith, DDS Dentist Medicare: Not Enrolled in Medicare Practice Location: 300 Prison Rd, Represa, CA 95671 Phone: 916-985-2561 Fax: 916-608-3105
Dennis Rulon Fairbourn, DMD Dentist Medicare: Not Enrolled in Medicare Practice Location: 100 Prison Road, California State Prison Sacramento, Represa, CA 95671 Phone: 910-985-8610 Fax: 916-294-3066

Changsu Park, D D S - Dentist in Represa, CA