DR. KONY PARK D.M.D NPI 1730433830

NPI Information

  • NPI: 1730433830
  • Provider Name: DR. KONY PARK, D.M.D
  • Classification: Dentist - 1223E0200X
  • Specialization: Endodontics
  • Entity Type: Individual
  • Address: 4913 MORELAND DR STE 103
    GEORGETOWN, TX
    ZIP 78633
  • Phone: (512) 275-4222

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NPI Details

DR. Kony Park, D.M.D is an endodontics dentist in Georgetown, TX. The provider is the branch of dentistry that is concerned with the morphology, physiology and pathology of the human dental pulp and periradicular tissues. Its study and practice encompass the basic and clinical sciences including biology of the normal pulp, the etiology, diagnosis, prevention and treatment of diseases and injuries of the pulp and associated periradicular conditions. DR. Kony Park, D.M.D NPI is 1730433830. 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:

4913 MORELAND DR STE 103
GEORGETOWN, TX
ZIP 78633-509
Phone: (512) 275-4222

The enumeration date for this NPI number is 10/29/2012 and was last updated on 1/16/2024.

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
11223E0200XDentistEndodontics36695TEXASYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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