CHAN M. PARK D.D.S. M.D. PC AND BENJAMIN R. SHIMEL D.D.S. PC A PA NPI 1124660014

NPI Information

  • NPI: 1124660014
  • Provider Name: CHAN M. PARK, D.D.S., M.D., PC AND BENJAMIN R. SHIMEL, D.D.S., PC A PA
  • Classification: Dentist - 1223S0112X
  • Specialization: Oral and Maxillofacial Surgery
  • Entity Type: Organization
  • Address: 111 DEERWOOD RD STE 130
    SAN RAMON, CA
    ZIP 94583
  • Phone: (925) 217-4884

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NPI Details

CHAN M. PARK, D.D.S., M.D., PC AND BENJAMIN R. SHIMEL, D.D.S., PC A PA is an oral and maxillofacial surgery dentist in San Ramon, CA. 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. CHAN M. PARK, D.D.S., M.D., PC AND BENJAMIN R. SHIMEL, D.D.S., PC A PA NPI is 1124660014. The provider is registered as an organization entity type and is a multiple single specialty group.

The provider's business location address is:

111 DEERWOOD RD STE 130
SAN RAMON, CA
ZIP 94583-194
Phone: (925) 217-4884
Fax: (925) 217-4895

The provider's authorized official is Chan M Park .
The authorized official title is Partner and has the following contact phone number (925) 217-4884.

The enumeration date for this NPI number is 10/11/2019 and was last updated on 10/11/2019.

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:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
11223S0112XDentistOral and Maxillofacial SurgeryYes

What is NPI?

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This page was last updated on: 3/30/2025

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