John Sir Park, in Broadlands, VA - Medicare Dentist Provider

John Sir Park, is a medicare enrolled "Dentist" provider in Broadlands, Virginia. His current practice location is 43170 Southern Walk Plz Ste 116, Broadlands, Virginia. You can reach out to his office (for appointments etc.) via phone at (703) 687-4320.

John Sir Park is licensed to practice in Virginia (license number 0401414285) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1336395243.

Contact Information

	John Sir Park,
	43170 Southern Walk Plz Ste 116, Broadlands, VA 20148-4464
	(703) 687-4320
	Not Available

Map and Direction

Healthcare Provider's Profile

Full Name	John Sir Park
Gender	Male
Speciality	Dentist
Location	43170 Southern Walk Plz Ste 116, Broadlands, Virginia
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1336395243
Provider Enumeration Date: 08/12/2008
Last Update Date: 03/23/2026

Medicare PECOS Information:

PECOS PAC ID: 3870805518
Enrollment ID: I20150708002825

Medical Identifiers

Medical identifiers for John Sir Park such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1336395243	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
122300000X	Dentist	0401414285 (Virginia)	Primary

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. John Sir 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
John Sir Park, 43170 Southern Walk Plz Ste 116, Broadlands, VA 20148-4464 Ph: (703) 687-4320	John Sir Park, 43170 Southern Walk Plz Ste 116, Broadlands, VA 20148-4464 Ph: (703) 687-4320

Reviews and Comments

Dentist in Broadlands, VA

Dr. Ramin Hessamfar, DMD., MS., PC Dentist Medicare: Not Enrolled in Medicare Practice Location: 42882 Truro Parish Dr, Suite 210, Broadlands, VA 20148 Phone: 703-726-6561 Fax: 703-726-6562
Dr. Ajit A Patel, D.D.S., M.S. Dentist Medicare: Not Enrolled in Medicare Practice Location: 42882 Truro Parish Dr, Suite 205, Broadlands, VA 20148 Phone: 703-726-4333 Fax: 703-726-4334
Dr. Zia Sibtain Rizvi, Dentist Medicare: Not Enrolled in Medicare Practice Location: 42882 Truro Parish Dr, Suite #208, Broadlands, VA 20148 Phone: 703-858-1904 Fax: 703-858-0840
Mr. Victor Han, DDS Dentist Medicare: Not Enrolled in Medicare Practice Location: 43150 Broadlands Center Plaza, Suite #158, Broadlands, VA 20148 Phone: 703-726-1600 Fax: 703-726-1607
Dr. Renuka Rao, DMD Dentist Medicare: Not Enrolled in Medicare Practice Location: 43170 Southern Walk Plz Ste 116, Broadlands, VA 20148 Phone: 703-687-4320
Dr. Pooya Aflatooni, DDS Dentist Medicare: Not Enrolled in Medicare Practice Location: 43170 Southern Walk Plz Ste 116, Broadlands, VA 20148 Phone: 703-984-9026

John Sir Park, - Medicare Dentist in Broadlands, VA