IndividualActive
Alice Park
NPI 1558047712 · General Practice Dentistry · San Diego, CA
Provider details
- NPI number
- 1558047712
- Entity type
- Individual
- Primary specialty
- General Practice DentistryDental Providers
- Sex
- Female
- Sole proprietor
- No
- License
- 112159 (CA)
Specialties & taxonomies
Dental Providers
Profile Score
Established profile(58/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
2 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
2310 Craven St
San Diego, CA 92136-4020
Phone: (619) 556-8240
Approximate (ZIP-level) locationGet directions
Mailing address
12198 Ferncrest Pl
San Diego, CA 92128-4349
Registry dates
- Enumerated
- 2023-06-23
- Last updated
- 2025-07-30
- Certified
- 2025-07-21
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.