Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1609448646 Individual Practitioner Male Practitioner

Dr. Samuel Park , DMD

Dentist • Tinker Afb, OK

Professional Overview & Biography Verified Profile Summary

Dr. Samuel Park, DMD is a registered healthcare professional specializing in Dentist in Tinker Afb, OK. Practice services are available at 7050 AIR DEPOT BLVD BLDG 1094 under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

7050 Air Depot Blvd Bldg 1094

Tinker Afb, OK 731458716

Telephone 9542907165

Specialty Benchmarks & Practice Insights

Comparative analytics for Dentist in Tinker Afb, OK

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 11.6 Yrs
Regional Practice Density
9 Specialists

Practicing in Tinker Afb, OK (1115 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: 2024-11-24
Dentist Primary Specialty

NUCC Taxonomy Code: 122300000X

State License VA 0401417587

A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist.

Secondary Practice Locations

76 Nealy Blvd Bldg 92

Hampton, VA 236652022

Phone: 7572257630

Practice Associates & Co-Workers

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

24 Associated Practitioners
Dr. Jamie Longmire , PharmD, BCPS

Pharmacist - Pharmacotherapy

NPI 1013257666

Doctor of Pharmacy (Pharm.D.), BCPS

Ramiro Garrido , PT

Physical Therapist

NPI 1033667365

Physical Therapist

Tonia Norman , RN

Registered Nurse - Ambulatory Care

NPI 1053158907

Registered Nurse

Christopher Smith

Social Worker

NPI 1083164438
NPI 1124332333

Doctor of Optometry

Craig Carpenter , LCSW

Social Worker - Clinical

NPI 1174890958

Licensed Clinical Social Worker

Career & Practice History Timeline

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

8 Historical Events
📍
Updated Practice Location November 24, 2024

Registered at 7050 AIR DEPOT BLVD BLDG 1094, TINKER AFB, OK 731458716 (Tel: 9542907165)

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) November 24, 2024

Dentist (License #0401417587 in VA)

NPI Profile Active July 10, 2021

NPI status registered as active in NPPES database

📍
Updated Practice Location July 10, 2021

Registered at 76 NEALY BLVD BLDG 92, HAMPTON, VA 236652022 (Tel: 7572257630)

📍
Updated Business Mailing Address July 10, 2021

Registered at 5306 TRACTOR LN, FAIRFAX, VA 220307239 (Tel: 9542907165)

👤
Provider Name / Credentials Updated July 10, 2021

Recorded as SAMUEL PARK, DMD

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) July 10, 2021

Student in an Organized Health Care Education/Training Program

🟢
Initial NPI Registration & Enumeration July 10, 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: 1609448646
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: July 10, 2021
Last Update: November 24, 2024
Sole Proprietor: No

Mailing Address

5306 Tractor Ln

Fairfax, VA 220307239

Phone: 9542907165

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.