Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
ETHAN SB PARK
Active Sole ProprietorETHAN SB PARK is a Dentist healthcare provider located in TEMPLE CITY, California. NPI 1144779828 is currently active in the NPPES registry. Verify at CMS.
Dentist · TEMPLE CITY, CA
Registration Details
- NPI Number
- 1144779828
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Sep 23, 2016 (9.7062426885295 yrs)
- Last Updated
- Jul 12, 2023
- Licenses
-
100873 (CA)100873 (CA)
- Sole Proprietor
- Yes
Practice Information
- Address
-
5728 ROSEMEAD BLVD UNIT 220TEMPLE CITY, CA, 917801814Browse CA providers · Browse ZIP 91780
- Phone
- 6265004340
- Fax
- 6265445335
- Primary Specialty
-
Dentist
122300000X
- Additional Specialty
- Dentist
Other Dentist Providers in TEMPLE CITY, CA
| Name | Credential | NPI |
|---|---|---|
| DR. KEN CHEUNG | DDS | 1942385000 |
| DR. WAN YI CHU | DDS | 1770611956 |
| DR. CHUNG HUN HAN | DDS | 1609099365 |
| DR. YIXIONG GU | — | 1972783066 |
| DR. JACK T. MA | D.D.S. | 1386814424 |
| DR. JACK VONBULOW | DDS | 1841431582 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.