DR. DOUGLAS LEE PARK DDS
NPI 1366521122
Dentist - Pediatric Dentistry in Gresham, OR

Active since November 03, 2006
1201 SE 223RD AVE, SUITE 240, GRESHAM, OR 97030(503) 666-9800(503) 666-6787 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Dr. Douglas Lee Park Dds NPPES

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

DR. DOUGLAS LEE PARK DDS (NPI 1366521122) is an individual pediatric dentistry provider in Gresham, Oregon, licensed in Oregon (D6620) and active in the NPI registry since November 2006.

NPPES Registry Identity

NPI1366521122
Entity TypeIndividualMale
Primary Taxonomy1223P0221X
Provider Legal NameDR. DOUGLAS LEE PARKCredential: DDS
Location Address1201 SE 223RD AVE, SUITE 240Gresham, OR 97030
Mailing Address34116 Se Carpenter LnGresham, OR 97080 · (503) 663-5162
Fax(503) 666-6787
Sole ProprietorNo
Enumeration DateNovember 3, 2006
Last NPPES UpdateJuly 8, 2007
NPI 1366521122 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyDentist · Pediatric DentistryDental Providers
Taxonomy Code1223P0221X
License Licensed in OR · D6620
Definition

An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs.

1201 SE 223RD AVE, Gresham, OR 97030

Other Identifiers 1

Medicare ID-Type Unspecified028030OR

Accepted Insurance

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.

Dentist (General Practice)
1201 SE 223RD AVE, SUITE 140
GRESHAM, OR 97030
Dentist (General Practice)
1201 SE 223RD AVE, SUITE 260
GRESHAM, OR 97030
Optometrist
1201 SE 223RD AVE, SUITE 160
GRESHAM, OR 97030
Dentist (Orthodontics and Dentofacial Orthopedics)
1201 SE 223RD AVE, SUITE 220
GRESHAM, OR 97030
Clinic/Center (Dental)
1201 SE 223RD AVE, SUITE 140
GRESHAM, OR 97030
Dentist (Oral and Maxillofacial Surgery)
1201 SE 223RD AVE, SUITE 180
GRESHAM, OR 97030

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 Douglas Park's NPI number?

The NPI number for Douglas Park is 1366521122. It was assigned to this individual provider in the NPPES registry on November 3, 2006.

Where is Douglas Park located?

Douglas Park practices at 1201 SE 223rd Ave Suite 240, Gresham, OR 97030. The listed phone number is (503) 666-9800.

What is Douglas Park's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Pediatric Dentistry, with taxonomy code 1223P0221X.

What insurance does Douglas Park accept?

Health plans from Delta Dental Plan of Oregon, Humana and PacificSource Health Plans list Douglas 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 Douglas Park was last updated on July 8, 2007. NPI Profile syncs with the weekly NPPES data releases published by CMS.