Zivin Park, in Portage, MI - Medicare Dentist Provider

Zivin Park, is a medicare enrolled "Dentist" provider in Portage, Michigan. His current practice location is 5200 S Westnedge Ave, Portage, Michigan. You can reach out to his office (for appointments etc.) via phone at (269) 382-6656.

Zivin Park is licensed to practice in Michigan (license number 2901021641) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1124409560.

Contact Information

	Zivin Park,
	5200 S Westnedge Ave, Portage, MI 49002
	(269) 382-6656
	Not Available

Healthcare Provider's Profile

Full Name	Zivin Park
Gender	Male
Speciality	Dentist
Location	5200 S Westnedge Ave, Portage, Michigan
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1124409560
Provider Enumeration Date: 06/11/2015
Last Update Date: 03/26/2021

Medicare PECOS Information:

PECOS PAC ID: 5193014397
Enrollment ID: I20160511000917

Medical Identifiers

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

Identifier	Type	State	Issuer
1124409560	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
122300000X	Dentist	2901021641 (Michigan)	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. Zivin 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
Zivin Park, Pmb 121-10001, Saipan, MP 96950 Ph: (670) 235-2378	Zivin Park, 5200 S Westnedge Ave, Portage, MI 49002 Ph: (269) 382-6656

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Dentist in Portage, MI

Dr. Frank Alley, DDS Dentist Medicare: Medicare Enrolled Practice Location: 7934 Ashton Woods Dr, Portage, MI 49024 Phone: 269-327-3290
Dr. Mary Ann Bukowski, D.D.S. Dentist Medicare: Not Enrolled in Medicare Practice Location: 1416 W Milham Ave, Portage, MI 49024 Phone: 269-381-0564 Fax: 269-381-4965
Dr. Marykay W Powell-steele, D.D.S. Dentist Medicare: Not Enrolled in Medicare Practice Location: 8080 Moorsbridge Rd, Suite 101, Portage, MI 49024 Phone: 269-323-3020 Fax: 269-323-0771
Dr. Chuandi Wang, D.D.S. Dentist Medicare: Not Enrolled in Medicare Practice Location: 5907 Oakland Dr, Portage, MI 49024 Phone: 269-327-4459
Ashley Kate Muehleise, DDS Dentist Medicare: Not Enrolled in Medicare Practice Location: 1414 E Centre Ave, Portage, MI 49002 Phone: 269-381-7770
Dr. David John Wadas, DDS Dentist Medicare: Not Enrolled in Medicare Practice Location: 636 E Milham Ave, Portage, MI 49002 Phone: 269-323-1802 Fax: 269-323-1940
Jacob Webb, DDS Dentist Medicare: Not Enrolled in Medicare Practice Location: 7934 Ashton Woods Dr, Portage, MI 49024 Phone: 269-501-9018

Zivin Park, - Medicare Dentist in Portage, MI