Update this page – If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS.
Organization
PARK PROFESSIONAL DENTAL CORP
Active
Organization
PARK PROFESSIONAL DENTAL CORP
Active
Other names
Smile Dental of Los Angeles
Organization subpart
No
Provider details
NPI number
Authorized official
MICHELLE PEEVY (RDO)
(661) 430-3283
Entity
Organization
Contact information
Practice address
600 W MANCHESTER AVE STE 2, LOS ANGELES, CA 90044
(323) 750-1582
Mailing address
600 W MANCHESTER AVE STE 2, LOS ANGELES, CA 90044-5700
(323) 750-1582
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
53724
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
53724
—
CA
Enumeration date
05/23/2018
Last updated
07/03/2018
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up