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AIDAN PARK DDS
NPI 1639626450
Dentist in Kenosha, WI

Active since September 09, 2016PECOS Enrolled
6430 GREEN BAY RD, KENOSHA, WI 53142(888) 988-4066(847) 496-4850 Get Directions Write a Review

NPPES record last updated: September 9, 2016. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Aidan Park Dds NPPES

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

AIDAN PARK DDS (NPI 1639626450) is an individual dentist in Kenosha, Wisconsin, licensed in Wisconsin (1001421) and active in the NPI registry since September 2016. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1639626450
Entity TypeIndividualMale
Primary Taxonomy122300000X
Provider Legal NameAIDAN PARKCredential: DDS
Location Address6430 GREEN BAY RDKenosha, WI 53142-2948
Mailing Address2050 E Algonquin Rd, Ste 610Schaumburg, IL 60173-4144 · (888) 988-4066 · Fax (847) 496-4850
Phone(888) 988-4066
Fax(847) 496-4850
Sole ProprietorYes
Enumeration DateSeptember 9, 2016
✔ NPI 1639626450 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentistDental Providers
Taxonomy Code122300000X
License✔ Licensed in WI · 1001421
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.
6430 GREEN BAY RD, Kenosha, WI 53142
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, BEST Life, Blue Cross and Blue Shield of Montana and more.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Aidan 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 53142 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
$82.92 typical visit price
range $53.90 – $163.24
Typical copayment $20.73 (range $13.47 – $40.81)
Most-billed visit code 99203
Established Patient
$67.37 typical visit price
range $17.40 – $133.76
Typical copayment $16.84 (range $4.35 – $33.44)
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 3

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

JASJOT CHAHIL DDS
Dentist
6430 GREEN BAY RD
KENOSHA, WI 53142
Kenosha County (888) 988-4066
KRUPA M PATEL
Dentist (General Practice)
6430 GREEN BAY RD
KENOSHA, WI 53142
Kenosha County (262) 653-3980
DONG SONG DDS
Dentist
6430 GREEN BAY RD
KENOSHA, WI 53142
Kenosha County (888) 988-4066

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 Aidan Park's NPI number?

The NPI number for Aidan Park is 1639626450. It was assigned to this individual provider in the NPPES registry on September 9, 2016.

Where is Aidan Park located?

Aidan Park practices at 6430 Green Bay Rd, Kenosha, WI 53142. The listed phone number is (888) 988-4066.

What is Aidan Park's specialty?

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

Is Aidan Park enrolled in Medicare?

Yes. Aidan Park is registered in the Medicare PECOS enrollment system.

What insurance does Aidan Park accept?

Health plans from Anthem Blue Cross and Blue Shield, BEST Life, Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma and Blue Cross and Blue Shield of Texas and 6 other insurers list Aidan 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 Aidan Park was last updated on September 9, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 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.