ETERN S PARK DDS MD NPI 1124289905

NPI Details

Etern S Park, DDS, MD is an oral and maxillofacial surgery dentist in Fargo, ND with 18 years of experience. The provider is an oral and maxillofacial surgery dentist specialized in the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region. Etern S Park, DDS, MD NPI is 1124289905. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

1717 UNIVERSITY DR S
FARGO, ND
ZIP 58103-939
Phone: (701) 234-2000

The NPI 1124289905 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

• Established patient office or other outpatient visit, 20-29 minutes (HCPCS:99213)
• New patient office or other outpatient visit, 30-44 minutes (HCPCS:99203)
• Established patient office or other outpatient visit, 10-19 minutes (HCPCS:99212)
• Melanoma (skin cancer) excision (HCPCS:NAN03)

The enumeration date for this NPI number is 6/24/2008 and was last updated on 2/11/2025.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available: