# SUSAN PARK DDS, PLLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1609734086
- **Authorized official:** SUSAN PARK (MEMBER)
- **Authorized official phone:** (206) 883-6720

## Contact information

- **Practice address:** 1370 116TH AVE NE STE 104, BELLEVUE, WA 98004-3825
- **Practice address phone:** (425) 747-3080
- **Mailing address:** 1370 116TH AVE NE STE 104, BELLEVUE, WA 98004-3825
- **Mailing address phone:** (425) 747-3080

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | — | NULL | Yes |
| 1223G0001X | General Practice Dentistry | — | — | Yes |

## Other

- **Enumeration date:** 01/13/2026
- **Last updated:** 01/13/2026