DR. ERIC PARK D.M.D
NPI 1144452830
Dentist - Orthodontics and Dentofacial Orthopedics in Douglasville, GA

Active since August 14, 2009Opted out of Medicare · through Jun 28, 2028
4935 STEWART MILL RD, SUITE 200, DOUGLASVILLE, GA 30135(770) 627-3042(770) 627-3243 Get Directions Write a Review

NPPES record last updated: November 5, 2010. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Dr. Eric Park D.m.d NPPES

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

DR. ERIC PARK D.M.D (NPI 1144452830) is an individual orthodontics and dentofacial orthopedics provider in Douglasville, Georgia, licensed in Georgia (012946) and active in the NPI registry since August 2009. He has opted out of Medicare through June 28, 2028 and remains eligible to order and refer.

NPPES Registry Identity

NPI1144452830
Entity TypeIndividualMale
Primary Taxonomy1223X0400X
Provider Legal NameDR. ERIC PARKCredential: D.M.D
Location Address4935 STEWART MILL RD, SUITE 200Douglasville, GA 30135-6733
Mailing Address97 Eagle Rock DrAcworth, GA 30101-1916
Fax(770) 627-3243
Sole ProprietorNo
Enumeration DateAugust 14, 2009
Last NPPES UpdateNovember 5, 2010
NPI 1144452830 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyDentist · Orthodontics and Dentofacial OrthopedicsDental Providers
Taxonomy Code1223X0400X
License Licensed in GA · 012946
Definition
That area of dentistry concerned with the supervision, guidance and correction of the growing or mature dentofacial structures, including those conditions that require movement of teeth or correction of malrelationships and malformations of their related structures and the adjustment of relationships between and among teeth and facial bones by the application of forces and/or the stimulation and redirection of functional forces within the craniofacial complex. Major responsibilities of orthodontic practice include the diagnosis, prevention, interception and treatment of all forms of malocclusion of the teeth and associated alterations in their surrounding structures; the design, application and control of functional and corrective appliances; and the guidance of the dentition and its supporting structures to attain and maintain optimum occlusal relations in physiologic and esthetic harmony among facial and cranial structures.
4935 STEWART MILL RD, Douglasville, GA 30135

Accepted Insurance

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

Opted out of Medicare

Dr. Eric Park D.m.d has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from June 28, 2016 through June 28, 2028.

Opt-Out Effective DateJune 28, 2016
Opt-Out In Effect ThroughJune 28, 2028Opt-out affidavits renew automatically every two years unless cancelled
Eligible to Order & Refer Part B Labs & Imaging Durable Medical Equipment Home Health Agency Power Mobility DevicesAn opted-out provider can still order and refer for Medicare patients in the categories marked above, even though their own services are not covered.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 30135 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
$88.06 typical visit price
range $56.84 – $172.43
Typical copayment $22.01 (range $14.21 – $43.10)
Most-billed visit code 99203
Established Patient
$70.85 typical visit price
range $18.22 – $140.40
Typical copayment $17.71 (range $4.55 – $35.10)
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 5

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

Massage Therapist
4935 STEWART MILL RD, STE 101
DOUGLASVILLE, GA 30135
Chiropractor
4935 STEWART MILL RD, SUITE 101
DOUGLASVILLE, GA 30135
Clinic/Center (Sleep Disorder Diagnostic)
4935 STEWART MILL RD, STE 275
DOUGLASVILLE, GA 30135
Clinic/Center (Sleep Disorder Diagnostic)
4935 STEWART MILL RD, STE 275
DOUGLASVILLE, GA 30135
Chiropractor
4935 STEWART MILL RD, SUITE 101
DOUGLASVILLE, GA 30135

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 Eric Park's NPI number?

The NPI number for Eric Park is 1144452830. It was assigned to this individual provider in the NPPES registry on August 14, 2009.

Where is Eric Park located?

Eric Park practices at 4935 Stewart Mill Rd Suite 200, Douglasville, GA 30135. The listed phone number is (770) 627-3042.

What is Eric Park's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Orthodontics and Dentofacial Orthopedics, with taxonomy code 1223X0400X.

Is Eric Park enrolled in Medicare?

No. Eric Park has opted out of Medicare through June 28, 2028. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out. The provider remains eligible to order and refer services for Medicare patients.

What insurance does Eric Park accept?

Health plans from Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma and Blue Cross and Blue Shield of Texas list Eric Park as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Eric Park was last updated on November 5, 2010. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 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.