TRACEY PARK DDS
NPI 1104306729
Dentist in Puyallup, WA

Q: What is Tracey Park's NPI number?

The NPI number for Tracey Park is 1104306729. It was assigned to this individual provider in the NPPES registry on August 14, 2018.

Q: What is Tracey Park's specialty?

The primary specialty registered for this NPI is Dentist with taxonomy code 122300000X.

Q: When was this NPI record last updated?

The NPPES record for Tracey Park was last updated on November 7, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.

Active since August 14, 2018PECOS Enrolled

702 S HILL PARK DR STE 201, PUYALLUP, WA 98373(855) 433-6825 Get Directions Write a Review

NPPES record last updated: November 7, 2023. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Nov 7, 2023, Apr 29, 2019, Aug 15, 2018 (3 updates tracked since 2018).

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About Tracey Park Dds NPPES

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

TRACEY PARK DDS (NPI 1104306729) is an individual dentist in Puyallup, Washington, licensed in Washington (DE60879733) and active in the NPI registry since August 2018. She is enrolled in Medicare PECOS and maintains 2 additional practice locations.

NPPES Registry Identity

NPI1104306729

Entity TypeIndividualFemale

Primary Taxonomy122300000X

Provider Legal NameTRACEY PARKCredential: DDS

Location Address702 S HILL PARK DR STE 201Puyallup, WA 98373-1426

Mailing Address6950 Ne Campus WayHillsboro, OR 97124-5611 · (855) 433-6825

Phone(855) 433-6825

Sole ProprietorNo

Enumeration DateAugust 14, 2018

Last NPPES UpdateNovember 7, 20233 updates tracked since enumeration

NPPES CertifiedNovember 7, 2023

✔ NPI 1104306729 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentistDental Providers

Taxonomy Code122300000X

License✔ Licensed in WA · DE60879733

Definition

A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist.

702 S HILL PARK DR STE 201, Puyallup, WA 98373

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Secondary Practice Locations 2

Location 1181 S 333rd St Ste 100Federal Way, WA 98003 · Phone (855) 433-6825

Location 2510 Washington Ave NKent, WA 98032-4453 · Phone (855) 433-6825

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Tracey Park Dds is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 98373 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$88.29 typical visit price

range $57.27 – $172.80

Typical copayment $22.07 (range $14.31 – $43.20)

Most-billed visit code 99203

Established Patient

$71.29 typical visit price

range $18.56 – $141.11

Typical copayment $17.82 (range $4.64 – $35.27)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 6

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

SHIEUN JANG

Dentist