Dr Tracy S Park, DDS in Ceres, CA - Medicare Dentist Provider

Dr Tracy S Park, DDS is a medicare enrolled "Dentist - General Practice" provider in Ceres, California. Her current practice location is 2760 3rd Street, Suite A, Ceres, California. You can reach out to her office (for appointments etc.) via phone at (209) 537-4427.

Dr Tracy S Park is licensed to practice in California (license number 41769) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1073615084.

Contact Information

	Dr Tracy S Park, DDS
	2760 3rd Street, Suite A, Ceres, CA 95307
	(209) 537-4427
	(209) 537-4437

Healthcare Provider's Profile

Full Name	Dr Tracy S Park
Gender	Female
Speciality	Dentist - General Practice
Location	2760 3rd Street, Ceres, California
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1073615084
Provider Enumeration Date: 09/01/2006
Last Update Date: 07/08/2007

Medicare PECOS Information:

PECOS PAC ID: 1355640988
Enrollment ID: I20160503000152

Medical Identifiers

Medical identifiers for Dr Tracy S Park such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1073615084	NPI	-	NPPES
B4176901	Other	CA	DENTI-CAL

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
1223G0001X	Dentist - General Practice	41769 (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. Dr Tracy S Park is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Dr Tracy S Park, DDS 2760 3rd Street, Suite A, Ceres, CA 95307 Ph: (209) 537-4427	Dr Tracy S Park, DDS 2760 3rd Street, Suite A, Ceres, CA 95307 Ph: (209) 537-4427

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Dentist in Ceres, CA

Dr. Mital Mukesh Patel, DDS Dentist Medicare: Not Enrolled in Medicare Practice Location: 2561 3rd St Ste B, Ceres, CA 95307 Phone: 209-538-9297
Ms. Katherine Anne Kucera, DDS Dentist Medicare: Not Enrolled in Medicare Practice Location: 3507 Morgan Rd, Ceres, CA 95307 Phone: 209-537-4673
Pawanjeet Singh Pannu, Dentist Medicare: Medicare Enrolled Practice Location: 1918 Glen Harbor Dr, Ceres, CA 95307 Phone: 718-594-2282
Pablo Madrigal Walle, DDS Dentist Medicare: Medicare Enrolled Practice Location: 3100 E Service Rd, Ceres, CA 95307 Phone: 209-542-9921
Richard Z Chen, DMD Dentist Medicare: Medicare Enrolled Practice Location: 1920 Memorial Dr, Ceres, CA 95307 Phone: 209-541-3001 Fax: 209-538-1096
Dr. Alan Salvador Hernandez Lara, DDS Dentist Medicare: Not Enrolled in Medicare Practice Location: 3100 E Service Rd Ste 101, Ceres, CA 95307 Phone: 209-542-9921

Dr Tracy S Park, DDS - Medicare Dentist in Ceres, CA