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
TRACY PARK D.D.S. A PROFESSIONAL CORPORATION
Active
Organization
TRACY PARK D.D.S. A PROFESSIONAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. TRACY SUN PARK (DENTIST/OWNER)
(209) 537-4427
Entity
Organization
Contact information
Practice address
2760 3RD STREET, SUITE A, CERES, CA 95307-3220
(209) 537-4427
(209) 537-4437
Mailing address
2760 3RD STREET, SUITE A, CERES, CA 95307-3220
(209) 537-4427
(209) 537-4437
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
261QD0000X
Dental Clinic/Center
41769
CA
Other
Enumeration date
05/10/2012
Last updated
08/03/2021
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