DR. SUZAN PARK DDS
NPI 1376775767
Dentist - General Practice in Oakland, CA
About Dr. Suzan Park Dds NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
DR. SUZAN PARK DDS (NPI 1376775767) is an individual general practice provider in Oakland, California, licensed in California (57046) and active in the NPI registry since August 2009. She is enrolled in Medicare PECOS.
NPPES Registry Identity
Specialties & Licenses
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Dr. Suzan Park Dds is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignment
Medicare enrollment records show Suzan Park reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Oakland, CA 94602
- Reassigned Medicare billing, California enrollment
- 900 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 94602 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Other Providers at the Same Location NPPES 20
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
OAKLAND, CA 94602
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 Suzan Park's NPI number?
The NPI number for Suzan Park is 1376775767. It was assigned to this individual provider in the NPPES registry on August 18, 2009.
Where is Suzan Park located?
Suzan Park practices at 1411 E 31st St, Oakland, CA 94602. The listed phone number is (510) 437-4101.
What is Suzan Park's specialty?
The primary specialty registered for this NPI is Dentist, specializing in General Practice, with taxonomy code 1223G0001X.
Is Suzan Park enrolled in Medicare?
Yes. Suzan Park is registered in the Medicare PECOS enrollment system.
Which organization bills Medicare for Suzan Park's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Suzan Park reassigns Medicare benefits to Alameda Health System (Oakland, CA). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Suzan Park's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
When was this NPI record last updated?
The NPPES record for Suzan Park was last updated on October 17, 2015. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 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.
# Dr. Suzan Park, DDS · NPI 1376775767
General Practice provider in Oakland, California. Individual provider, active in the CMS NPPES registry since August 18, 2009.
## Identity
- **NPI:** 1376775767 (Entity type: Individual)
- **Enumerated:** August 18, 2009
- **Primary specialty:** Dentist - General Practice · taxonomy 1223G0001X
- **State license:** 57046 (California)
- **Sole proprietor:** No
## Practice location
- **Address:** 1411 E 31ST ST, Oakland, CA 94602-1018
- **Phone:** (510) 437-4101
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health
- **Bills Medicare through:** Alameda Health System (NPI 1740332931, Oakland, CA), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** October 17, 2015
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Source: [NPI Profile](https://npiprofile.com/npi/1376775767) · Data from the CMS NPPES public registry.