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Active NPI 1740306414 Individual Practitioner Male Practitioner

Dr. Kwonil Park , DDS

Dentist - General Practice • Carrollton, TX

Professional Overview & Biography Verified Profile Summary

Dr. Kwonil Park, DDS is a registered healthcare professional specializing in Dentist - General Practice in Carrollton, TX. Practice services are available at 1017 E TRINITY MILLS RD under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

1017 E Trinity Mills Rd
Suite 102

Carrollton, TX 750061438

Telephone 9724467733
Fax 9724460088
Associated Practice Facility / Clinic
🏢 Logos Assocation Inc. Facility NPI 1528243169

Specialty Benchmarks & Practice Insights

Comparative analytics for Dentist - General Practice in Carrollton, TX

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 12.3 Yrs
Regional Practice Density
81 Specialists

Practicing in Carrollton, TX (10570 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

Dentist - General Practice Primary Specialty

NUCC Taxonomy Code: 1223G0001X

State License TX 25071

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.

Dentist

NUCC Taxonomy Code: 122300000X

State License IL 019026108

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.

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID
1005790 (IL)
Medicaid State Provider ID
207002108 (TX)

Practice Associates & Co-Workers

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

1 Associated Practitioners
Dr. Myung Soo Choi , DDS

Dentist - Periodontics

NPI 1396040705

Doctor of Dental Surgery

Career & Practice History Timeline

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

6 Historical Events
NPI Profile Active January 11, 2011

NPI status registered as active in NPPES database

📍
Updated Practice Location January 11, 2011

Registered at 1017 E TRINITY MILLS RD, SUITE 102, CARROLLTON, TX 750061438 (Tel: 9724467733)

📍
Updated Business Mailing Address January 11, 2011

Registered at 1017 E TRINITY MILLS RD, SUITE 102, CARROLLTON, TX 750061438 (Tel: 9724467733)

👤
Provider Name / Credentials Updated January 11, 2011

Recorded as KWONIL PARK, DDS

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) January 11, 2011

Dentist (License #019026108 in IL)

🟢
Initial NPI Registration & Enumeration March 22, 2007

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: 1740306414
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: March 22, 2007
Last Update: January 11, 2011
Sole Proprietor: Yes

Mailing Address

1017 E Trinity Mills Rd, Suite 102

Carrollton, TX 750061438

Phone: 9724467733

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.