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UPPER WEST SIDE ORAL & MAXILLOFACIAL SURGERY
NPI 1053921643
Dentist - Oral and Maxillofacial Surgery in New York, NY

Active since August 07, 2020
140 W 69TH ST PH 1G, NEW YORK, NY 10023(646) 734-6742 Get Directions Write a Review

NPPES record last updated: August 7, 2020. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Upper West Side Oral & Maxillofacial Surgery NPPES

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

UPPER WEST SIDE ORAL & MAXILLOFACIAL SURGERY (NPI 1053921643) is a healthcare organization registered as an oral and maxillofacial surgery in New York, New York and active in the NPI registry since August 2020. The organization lists Nam Park, Dds, Md, as its authorized official.

NPPES Registry Identity

NPI1053921643
Entity TypeOrganization
Primary Taxonomy1223S0112X
Legal Business NameUPPER WEST SIDE ORAL & MAXILLOFACIAL SURGERY
Location Address140 W 69TH ST PH 1GNew York, NY 10023-5173
Mailing Address140 W 69th St Ph 1gNew York, NY 10023-5173
Phone(646) 734-6742
Organization SubpartNo
Authorized OfficialNam ParkDds, Md · (646) 734-6742
Enumeration DateAugust 7, 2020
NPPES CertifiedAugust 7, 2020
✔ NPI 1053921643 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · Oral and Maxillofacial SurgeryDental Providers
Taxonomy Code1223S0112X
Definition

An oral and maxillofacial surgery dentist specialized in the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region.

140 W 69TH ST PH 1G, New York, NY 10023
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

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 Upper West Side Oral & Maxillofacial Surgery's NPI number?

The NPI number for Upper West Side Oral & Maxillofacial Surgery is 1053921643. It was assigned to this organization in the NPPES registry on August 7, 2020.

Where is Upper West Side Oral & Maxillofacial Surgery located?

Upper West Side Oral & Maxillofacial Surgery is located at 140 W 69th St Ph 1G, New York, NY 10023. The listed phone number is (646) 734-6742.

What is Upper West Side Oral & Maxillofacial Surgery's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Oral and Maxillofacial Surgery, with taxonomy code 1223S0112X.

When was this NPI record last updated?

The NPPES record for Upper West Side Oral & Maxillofacial Surgery was last updated on August 7, 2020. NPI Profile syncs with the weekly NPPES data releases published by CMS.