DR. DAVID A PARK M.D., D.D.S.
NPI 1750404786
Dentist - Oral and Maxillofacial Surgery in Provo, UT

Q: What is David Park's NPI number?

The NPI number for David Park is 1750404786. It was assigned to this individual provider in the NPPES registry on April 6, 2007.

Q: What is David Park's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Oral and Maxillofacial Surgery, with taxonomy code 1223S0112X.

Q: Is David Park enrolled in Medicare?

No. David Park has opted out of Medicare through May 12, 2028. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out.

Q: When was this NPI record last updated?

The NPPES record for David Park was last updated on July 28, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 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.

Active since April 06, 2007Opted out of Medicare · through May 12, 2028

3610 N UNIVERSITY AVE, SUITE 150, PROVO, UT 84604(801) 356-2226(801) 812-1734 Get Directions Write a Review

NPPES record last updated: July 28, 2008. Verified against the NPPES registry weekly; last sync: August 23, 2026.

On this page

About Dr. David A Park M.d., D.d.s. NPPES

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

DR. DAVID A PARK M.D., D.D.S. (NPI 1750404786) is an individual oral and maxillofacial surgery provider in Provo, Utah, licensed in Utah (5129759) and active in the NPI registry since April 2007. He has opted out of Medicare through May 12, 2028.

NPPES Registry Identity

NPI1750404786

Entity TypeIndividualMale

Primary Taxonomy1223S0112X

Provider Legal NameDR. DAVID A PARKCredential: M.D., D.D.S.

Location Address3610 N UNIVERSITY AVE, SUITE 150Provo, UT 84604-4437

Mailing Address3610 N University Ave, Suite 150Provo, UT 84604-4437 · (801) 356-2226 · Fax (801) 812-1734

Phone(801) 356-2226

Fax(801) 812-1734

Sole ProprietorNo

Enumeration DateApril 6, 2007

Last NPPES UpdateJuly 28, 2008

✔ NPI 1750404786 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · Oral and Maxillofacial SurgeryDental Providers

Taxonomy Code1223S0112X

License✔ Licensed in UT · 5129759

Definition

An oral and maxillofacial surgery dentist specialized in the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region.

3610 N UNIVERSITY AVE, Provo, UT 84604

Open in Google Maps ↗

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include BEST Life, Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma and more.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. David A Park M.d., D.d.s. 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 May 12, 2026 through May 12, 2028.

Opt-Out Effective DateMay 12, 2026

Opt-Out In Effect ThroughMay 12, 2028Opt-out affidavits renew automatically every two years unless cancelled

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.

UTAH SURGICAL ARTS

Clinic/Center (Oral and Maxillofacial Surgery)

3610 N UNIVERSITY AVE, SUITE 150
PROVO, UT 84604

Utah County (801) 356-2226

BLAKE LYNN MATTHEWS DDS

Dentist (General Practice)

3610 N UNIVERSITY AVE, #200
PROVO, UT 84604

Utah County (801) 377-9600

JEFFREY L TRAPNELL D.D.S.

Dentist (Orthodontics and Dentofacial Orthopedics)

3610 N UNIVERSITY AVE, SUITE #175
PROVO, UT 84604

Utah County (801) 344-8887

DR. MICHAEL D HARRIS M.D., D.D.S.

Dentist (Oral and Maxillofacial Surgery)

3610 N UNIVERSITY AVE, SUITE 150
PROVO, UT 84604

Utah County (801) 356-2226

JONATHAN ASHMAN DMD

Dentist (General Practice)

3610 N UNIVERSITY AVE
PROVO, UT 84604

Utah County (801) 377-9600

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 David Park's NPI number?

The NPI number for David Park is 1750404786. It was assigned to this individual provider in the NPPES registry on April 6, 2007.

Where is David Park located?

David Park practices at 3610 N University Ave Suite 150, Provo, UT 84604. The listed phone number is (801) 356-2226.

What is David Park's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Oral and Maxillofacial Surgery, with taxonomy code 1223S0112X.

Is David Park enrolled in Medicare?

No. David Park has opted out of Medicare through May 12, 2028. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out.

What insurance does David Park accept?

Health plans from BEST Life, Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma, Blue Cross and Blue Shield of Texas and BridgeSpan Health Company and 10 other insurers list David 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 David Park was last updated on July 28, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 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.