Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1497323315 Individual Practitioner Female Practitioner

Dr. Lucienne Park , DMD

Dentist - General Practice • Jacksonville, FL

Professional Overview & Biography Verified Profile Summary

Dr. Lucienne Park, DMD is a registered healthcare professional specializing in Dentist - General Practice in Jacksonville, FL. Practice services are available at 5753 BEACH BLVD STE 4 under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

5753 Beach Blvd Ste 4

Jacksonville, FL 322075128

Telephone 9044411642
Associated Practice Facility / Clinic

Specialty Benchmarks & Practice Insights

Comparative analytics for Dentist - General Practice in Jacksonville, FL

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 15.0 Yrs
Regional Practice Density
363 Specialists

Practicing in Jacksonville, FL (7473 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

CMS Verified: 2025-06-06
Dentist - General Practice Primary Specialty

NUCC Taxonomy Code: 1223G0001X

State License FL DN27006

A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

1 Associated Practitioners
Dr. Justin Le , DMD

Dentist - General Practice

NPI 1245078781

Doctor of Dental Medicine

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

17 Historical Events
📍
Updated Practice Location June 06, 2025

Registered at 5753 BEACH BLVD STE 4, JACKSONVILLE, FL 322075128 (Tel: 9044411642)

📍
Updated Business Mailing Address June 06, 2025

Registered at 5753 BEACH BLVD STE 4, JACKSONVILLE, FL 322075128

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) June 06, 2025

Dentist (License #DN27006 in FL)

📍
Updated Business Mailing Address July 08, 2024

Registered at 230 S 12TH AVE, PHOENIX, AZ 850073101

📍
Updated Practice Location July 05, 2024

Registered at 230 S 12TH AVE, PHOENIX, AZ 850073101 (Tel: 6023620744)

📍
Updated Business Mailing Address July 05, 2024

Registered at 1505 N CENTRAL AVE APT 525, PHOENIX, AZ 850041731 (Tel: 3016650070)

📍
Updated Practice Location April 16, 2023

Registered at 4000 SAINT JOHNS AVE APT 6318, JACKSONVILLE, FL 322059488 (Tel: 3016650070)

📍
Updated Business Mailing Address April 16, 2023

Registered at 11912 FERNSHIRE RD, GAITHERSBURG, MD 208782008 (Tel: 3016650070)

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) April 16, 2023

Student in an Organized Health Care Education/Training Program

📍
Updated Business Mailing Address September 09, 2022

Registered at 1985 EASTWEST PKWY, FLEMING ISLAND, FL 320038017 (Tel: 3016650070)

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) September 09, 2022

Dentist (License #DN27006 in FL)

NPI Profile Active June 16, 2021

NPI status registered as active in NPPES database

📍
Updated Practice Location June 16, 2021

Registered at 1111 N CHARLES ST, BALTIMORE, MD 212015505 (Tel: 3016650070)

📍
Updated Business Mailing Address June 16, 2021

Registered at 11912 FERNSHIRE RD, GAITHERSBURG, MD 208782008 (Tel: 3016650070)

👤
Provider Name / Credentials Updated June 16, 2021

Recorded as LUCIENNE PARK, DMD

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) June 16, 2021

Student in an Organized Health Care Education/Training Program

🟢
Initial NPI Registration & Enumeration June 16, 2021

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1497323315
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: June 16, 2021
Last Update: June 06, 2025
Sole Proprietor: Yes

Mailing Address

5753 Beach Blvd Ste 4

Jacksonville, FL 322075128

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.