| Sun- Park Dental | |
|
5400 Park Dr # 100 Rocklin CA 95765-5562 | |
| (916) 435-1155 | |
| (916) 435-1152 |
| Full Name | Sun- Park Dental |
|---|---|
| Speciality | Clinic/Center |
| Location | 5400 Park Dr # 100, Rocklin, California |
| Authorized Official Name and Position | Minh Nguyen (CEO) |
| Authorized Official Contact | 9163902784 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Sun- Park Dental 5400 Park Dr # 100 Rocklin CA 95765-5562 Ph: (916) 435-1155 | Sun- Park Dental 5400 Park Dr # 100 Rocklin CA 95765-5562 Ph: (916) 435-1155 |
| NPI Number | 1992356075 |
|---|---|
| Provider Enumeration Date | 09/20/2019 |
| Last Update Date | 01/13/2021 |
| Medicare PECOS PAC ID | 4486986049 |
|---|---|
| Medicare Enrollment ID | O20191031000567 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1992356075 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
| 332BC3200X | Durable Medical Equipment & Medical Supplies - Customized Equipment | (* (Not Available)) | Secondary |
| Provider Name | Minh B Nguyen |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1447390273 PECOS PAC ID: 4587996145 Enrollment ID: I20191031000545 |
| Provider Name | Thanh-truc T Nguyen |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1043350879 PECOS PAC ID: 0345676797 Enrollment ID: I20200204001270 |
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