IndividualActive
Dong Park, DDS
NPI 1013963230 · Periodontics · Chantilly, VA
Provider details
- NPI number
- 1013963230
- Entity type
- Individual
- Primary specialty
- PeriodonticsDental Providers
- Credential
- DDS
- Sex
- Male
- Sole proprietor
- Yes
- License
- 0401414636 (VA)
Practice location
14100 Park Meadow Dr Ste 110
Chantilly, VA 20151-2292
Phone: (703) 466-5115
Fax: (703) 466-5502
Mailing address
14100 Park Meadow Dr Ste 110
Chantilly, VA 20151-2292
Registry dates
- Enumerated
- 2006-05-26
- Last updated
- 2023-03-20
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.