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DR. BODANIELLE S PARK L.AC, PHDOM
NPI 1013287150
Acupuncturist in Lawrenceville, GA

Active since January 06, 2012
333 SWANSON DR STE 102, LAWRENCEVILLE, GA 30043(678) 878-3069(678) 878-4455 Get Directions Write a Review

NPPES record last updated: February 17, 2021. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Feb 17, 2021, Nov 1, 2017 (2 updates tracked since 2017).

About Dr. Bodanielle S Park L.ac, Phdom NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. BODANIELLE S PARK L.AC, PHDOM (NPI 1013287150) is an individual acupuncturist in Lawrenceville, Georgia, licensed in Georgia (355) and active in the NPI registry since January 2012. She maintains a secondary practice location in Duluth.

NPPES Registry Identity

NPI1013287150
Entity TypeIndividualFemale
Primary Taxonomy171100000X
Provider Legal NameDR. BODANIELLE S PARKCredential: L.AC, PHDOM
Location Address333 SWANSON DR STE 102Lawrenceville, GA 30043-8537
Mailing AddressPo Box 490186Lawrenceville, GA 30049-0004 · (678) 878-3069 · Fax (678) 878-4455
Phone(678) 878-3069
Fax(678) 878-4455
Sole ProprietorYes
Enumeration DateJanuary 6, 2012
Last NPPES UpdateFebruary 17, 20212 updates tracked since enumeration
NPPES CertifiedFebruary 17, 2021
✔ NPI 1013287150 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyAcupuncturistOther Service Providers
Taxonomy Code171100000X
License✔ Licensed in GA · 355
Definition
An acupuncturist is a person who performs ancient therapy for alleviation of pain, anesthesia and treatment of some diseases. Acupuncturists use long, fine needles inserted into specific points in order to treat painful conditions or produce anesthesia.
333 SWANSON DR STE 102, Lawrenceville, GA 30043
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Secondary Practice Location 1

Location 13400 McClure Bridge Rd Ste C304Duluth, GA 30096-8706 · Phone (678) 878-3069 · Fax (678) 878-4455

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

RANDY CABIL MASSAGE THERAPIST
Massage Therapist
333 SWANSON DR STE 102
LAWRENCEVILLE, GA 30043
Gwinnett County (678) 878-3069
A PLUS TOTAL HEALTH CONNECTION LLC
Acupuncturist
333 SWANSON DR STE 102
LAWRENCEVILLE, GA 30043
Gwinnett County (678) 878-3069

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Bodanielle Park's NPI number?

The NPI number for Bodanielle Park is 1013287150. It was assigned to this individual provider in the NPPES registry on January 6, 2012.

Where is Bodanielle Park located?

Bodanielle Park practices at 333 Swanson Dr Ste 102, Lawrenceville, GA 30043. The listed phone number is (678) 878-3069.

What is Bodanielle Park's specialty?

The primary specialty registered for this NPI is Acupuncturist with taxonomy code 171100000X.

When was this NPI record last updated?

The NPPES record for Bodanielle Park was last updated on February 17, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.