Park, James
Park, James is an sole proprietor health care provider with primary practice located at 359 S Washington Ave , Bergenfield NJ 07621-4311. He recently has only one registered license in Dental Providers / General Practice, which is considered as his primary health care specialty. Park, James can be contacted via phone (201) 385-2500.Contact Information
Primary practice address
359 S Washington Ave
Bergenfield NJ 07621-4311
Phone: (201) 385-2500
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / General Practice | 1223G0001X | 050126-1 | New York |
| Dental Providers / General Practice | 1223G0001X | 22DI02194700 | New Jersey |
| Dental Providers / General Practice | 1223G0001X | 13122 | Maryland |
Profile Details
| NPI number | 1134272719 |
|---|---|
| LBN Legal business name | Park, James |
| Credentials | Doctor of Dental Surgery (DDS) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jan 18th, 2007 |
| Last updated | Nov 23rd, 2015 - about 11 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1134272719 | NPPES |
| New York | MEDICAID | 02779124 |
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