SAMUEL PARK DMD
NPI 1609448646
Dentist in Tinker Afb, OK

Q: What is Samuel Park's NPI number?

The NPI number for Samuel Park is 1609448646. It was assigned to this individual provider in the NPPES registry on July 10, 2021.

Q: What is Samuel 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 Samuel Park was last updated on November 24, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 20 months 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 July 10, 2021

7050 AIR DEPOT BLVD BLDG 1094, TINKER AFB, OK 73145(954) 290-7165 Get Directions Write a Review

NPPES record last updated: November 24, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Nov 24, 2024, Jul 10, 2021 (2 updates tracked since 2021).

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About Samuel Park Dmd NPPES

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

SAMUEL PARK DMD (NPI 1609448646) is an individual dentist in Tinker Afb, Oklahoma, licensed in Virginia (0401417587) and active in the NPI registry since July 2021. He maintains a secondary practice location in Hampton.

NPPES Registry Identity

NPI1609448646

Entity TypeIndividualMale

Primary Taxonomy122300000X

Provider Legal NameSAMUEL PARKCredential: DMD

Location Address7050 AIR DEPOT BLVD BLDG 1094Tinker Afb, OK 73145-8716

Mailing Address5306 Tractor LnFairfax, VA 22030-7239 · (954) 290-7165

Phone(954) 290-7165

Sole ProprietorNo

Enumeration DateJuly 10, 2021

Last NPPES UpdateNovember 24, 20242 updates tracked since enumeration

NPPES CertifiedNovember 24, 2024

✔ NPI 1609448646 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentistDental Providers

Taxonomy Code122300000X

License✔ Licensed in VA · 0401417587

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.

7050 AIR DEPOT BLVD BLDG 1094, Tinker Afb, OK 73145

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Secondary Practice Location 1

Location 176 Nealy Blvd Bldg 92Hampton, VA 23665-2022 · Phone (757) 225-7630

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.

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