Dr Mindy Park, DDS in Northridge, CA - Medicare Dentist Provider

Dr Mindy Park, DDS is a medicare enrolled "Dentist - Oral And Maxillofacial Surgery" provider in Northridge, California. Her current practice location is 8345 Reseda Blvd. #101, Northridge, California. You can reach out to her office (for appointments etc.) via phone at (818) 576-9990.

Dr Mindy Park is licensed to practice in California (license number 54241) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1417257767.

Contact Information

	Dr Mindy Park, DDS
	8345 Reseda Blvd. #101, Northridge, CA 91324
	(818) 576-9990
	Not Available

Map and Direction

Healthcare Provider's Profile

Full Name	Dr Mindy Park
Gender	Female
Speciality	Dentist - Oral And Maxillofacial Surgery
Location	8345 Reseda Blvd. #101, Northridge, California
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1417257767
Provider Enumeration Date: 11/02/2010
Last Update Date: 10/11/2023

Medicare PECOS Information:

PECOS PAC ID: 8628335502
Enrollment ID: I20171130002827

Medical Identifiers

Medical identifiers for Dr Mindy Park such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1417257767	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
1223G0001X	Dentist - General Practice	54241 (California)	Secondary
1223S0112X	Dentist - Oral And Maxillofacial Surgery	54241 (California)	Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Dr Mindy Park allows following entities to bill medicare on her behalf.

Entity Name	Valley Ace Dental Group Joint
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1548540552 PECOS PAC ID: 1052677820 Enrollment ID: O20171110000836

Entity Name	Mindy Park Dds Inc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1063231090 PECOS PAC ID: 7810425451 Enrollment ID: O20250110001787

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Mindy Park is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Dr Mindy Park, DDS 8345 Reseda Blvd. #101, Northridge, CA 91324 Ph: () -	Dr Mindy Park, DDS 8345 Reseda Blvd. #101, Northridge, CA 91324 Ph: (818) 576-9990

Reviews and Comments

Dentist in Northridge, CA

Mr. Frank H Hackman, DDS Dentist Medicare: Medicare Enrolled Practice Location: 8864 Corbin Ave, All Family Dental Care, Northridge, CA 91324 Phone: 818-700-7980 Fax: 818-709-7830
Fariba Kohanghadosh, DDS Dentist Medicare: Not Enrolled in Medicare Practice Location: 18433 Roscoe Blvd, Northridge, CA 91325 Phone: 818-882-0100
Rong Zhang, DDS Dentist Medicare: Not Enrolled in Medicare Practice Location: 10141 Lasaine Ave, Northridge, CA 91325 Phone: 310-985-4975
Dr. Tam-huong Ngoc Tran, DDS Dentist Medicare: Not Enrolled in Medicare Practice Location: 11155 Tampa Ave, Northridge, CA 91326 Phone: 818-363-3382 Fax: 818-363-4002
Aidailis Capestany, D.D.S Dentist Medicare: Not Enrolled in Medicare Practice Location: 8540 Reseda Blvd Ste 101, Northridge, CA 91324 Phone: 818-701-6667
Knud G Flygenring, DDS Dentist Medicare: Not Enrolled in Medicare Practice Location: 17300 Nordhoff Street, Northridge, CA 91325 Phone: 818-886-0991 Fax: 818-885-8461
Dr. Carmen Agapin Magpantay, Dentist Medicare: Medicare Enrolled Practice Location: 10321 Zelzah Ave, Northridge, CA 91326 Phone: 818-366-4118 Fax: 818-366-6098

Dr Mindy Park, DDS - Medicare Dentist in Northridge, CA