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Active NPI 1730433830 Individual Practitioner Male Practitioner

Dr. Kony Park , DMD

Dentist - Endodontics • Georgetown, TX

Professional Overview & Biography Verified Profile Summary

Dr. Kony Park, DMD is a registered healthcare professional specializing in Dentist - Endodontics in Georgetown, TX. Practice services are available at 4913 MORELAND DR STE 103 under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

4913 Moreland Dr Ste 103

Georgetown, TX 786335509

Telephone 5122754222
Associated Practice Facility / Clinic

Specialty Benchmarks & Practice Insights

Comparative analytics for Dentist - Endodontics in Georgetown, TX

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 10.2 Yrs
Regional Practice Density
3 Specialists

Practicing in Georgetown, TX (476 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: 2024-01-16
Dentist - Endodontics Primary Specialty

NUCC Taxonomy Code: 1223E0200X

State License TX 36695

The branch of dentistry that is concerned with the morphology, physiology and pathology of the human dental pulp and periradicular tissues. Its study and practice encompass the basic and clinical sciences including biology of the normal pulp, the etiology, diagnosis, prevention and treatment of diseases and injuries of the pulp and associated periradicular conditions.

Practice Associates & Co-Workers

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

1 Associated Practitioners
NPI 1437469483

Doctor of Dental Surgery

Career & Practice History Timeline

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

9 Historical Events
📍
Updated Practice Location January 16, 2024

Registered at 4913 MORELAND DR STE 103, GEORGETOWN, TX 786335509 (Tel: 5122754222)

📍
Updated Business Mailing Address January 16, 2024

Registered at 30102 DIAMOND DOVE TRL, GEORGETOWN, TX 786283724 (Tel: 2535039655)

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) January 16, 2024

Dentist (License #36695 in TX)

NPI Profile Active August 20, 2016

NPI status registered as active in NPPES database

📍
Updated Practice Location August 20, 2016

Registered at LANDSTUHL DENTAL ACTIVITY, HQ, MARCEAU KASERNE BLDG 3703, RM 205, LANDSTUHL, KIRCHBERG 09180 (Tel: 06371929130)

📍
Updated Business Mailing Address August 20, 2016

Registered at LANDSTUHL DENTAC, CMR 402, APO, AE 09180 (Tel: 4963719464431)

👤
Provider Name / Credentials Updated August 20, 2016

Recorded as KONY PARK, D.M.D

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) August 20, 2016

Dentist (License #DE60312639 in WA)

🟢
Initial NPI Registration & Enumeration October 29, 2012

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: 1730433830
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: October 29, 2012
Last Update: January 16, 2024
Sole Proprietor: No

Mailing Address

30102 Diamond Dove Trl

Georgetown, TX 786283724

Phone: 2535039655

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.