Jim Park, D.D.S
NPI 1912116104 · Dentist · Riverside, CA
Enrolled with Medicare as Order and Referring Only - Dentist · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Jim Park, D.D.S is a Dentist provider in Riverside, CA (NPI 1912116104).
Provider details
- NPI number
- 1912116104
- Entity type
- Individual
- Primary specialty
- DentistDental Providers
- Credential
- D.D.S
- Sex
- Male
- Sole proprietor
- Yes
- License
- 47545 (CA)
Specialties & taxonomies
Dental Providers
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
19 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
Mailing address
Registry dates
- Enumerated
- 2007-05-22
- Last updated
- 2007-07-08
Frequently asked questions
- What is Jim Park's NPI number?
- Jim Park's National Provider Identifier (NPI) is 1912116104, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What is Jim Park's specialty?
- Jim Park is listed in the NPPES registry with a primary specialty of Dentist (Dental Providers).
- Where is Jim Park located?
- Jim Park's practice location on file with NPPES is 4710 La Sierra Ave, Riverside, CA 92505-2726.
- What is Jim Park's phone number?
- The practice phone number listed in the NPPES registry for Jim Park is (951) 324-8180.
- Does Jim Park accept Medicare?
- Jim Park is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Is Jim Park's NPI active?
- Yes — Jim Park's NPI (1912116104) is active in the NPPES registry as of the last update on 2007-07-08.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.