KIDEOG PARK
NPI 1861010845
Dentist - General Practice in Garden Grove, CA

Q: What is Kideog Park's NPI number?

The NPI number for Kideog Park is 1861010845. It was assigned to this individual provider in the NPPES registry on July 7, 2020.

Q: What is Kideog Park's specialty?

The primary specialty registered for this NPI is Dentist, specializing in General Practice, with taxonomy code 1223G0001X.

Q: When was this NPI record last updated?

The NPPES record for Kideog Park was last updated on July 7, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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 July 07, 2020

9618 GARDEN GROVE BLVD STE 208, GARDEN GROVE, CA 92844(714) 537-9380(714) 537-2593 Get Directions Write a Review

NPPES record last updated: July 7, 2020. Verified against the NPPES registry weekly; last sync: August 16, 2026.

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About Kideog Park NPPES

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

KIDEOG PARK (NPI 1861010845) is an individual general practice provider in Garden Grove, California, licensed in California (102006) and active in the NPI registry since July 2020.

NPPES Registry Identity

NPI1861010845

Entity TypeIndividualMale

Primary Taxonomy1223G0001X

Provider Legal NameKIDEOG PARK

Location Address9618 GARDEN GROVE BLVD STE 208Garden Grove, CA 92844-1566

Mailing Address9618 Garden Grove Blvd Ste 208Garden Grove, CA 92844-1566 · (714) 537-9380 · Fax (714) 537-2593

Phone(714) 537-9380

Fax(714) 537-2593

Sole ProprietorNo

Enumeration DateJuly 7, 2020

NPPES CertifiedJuly 7, 2020

✔ NPI 1861010845 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · General PracticeDental Providers

Taxonomy Code1223G0001X

License✔ Licensed in CA · 102006

Definition

A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.

9618 GARDEN GROVE BLVD STE 208, Garden Grove, CA 92844

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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 Kideog Park's NPI number?

The NPI number for Kideog Park is 1861010845. It was assigned to this individual provider in the NPPES registry on July 7, 2020.

Where is Kideog Park located?

Kideog Park practices at 9618 Garden Grove Blvd Ste 208, Garden Grove, CA 92844. The listed phone number is (714) 537-9380.

What is Kideog Park's specialty?

The primary specialty registered for this NPI is Dentist, specializing in General Practice, with taxonomy code 1223G0001X.

When was this NPI record last updated?

The NPPES record for Kideog Park was last updated on July 7, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.