Provider Demographics
NPI:1144840075
Name:PARK, JANET (DDS, MS)
Entity type:Individual
Prefix:
First Name:JANET
Middle Name:
Last Name:PARK
Suffix:
Gender:F
Credentials:DDS, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3935 CASCADE SKY DR
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76005-1123
Mailing Address - Country:US
Mailing Address - Phone:646-491-1035
Mailing Address - Fax:
Practice Address - Street 1:100 HUDSON OAKS DR
Practice Address - Street 2:
Practice Address - City:HUDSON OAKS
Practice Address - State:TX
Practice Address - Zip Code:76087-4712
Practice Address - Country:US
Practice Address - Phone:817-717-9653
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-04-21
Last Update Date:2025-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX383951223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics