Derek Park, DDS

General Practice Dentistry · Monroe, WA

Individual Active NPI

NPI number 1700778172

Practice location

623 W Main St
Monroe, WA 98272-2101
Phone
(360) 805-9060

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NPI record

NPI
1700778172
Entity type
Individual (Type 1)
Enumeration date
July 18, 2025
Last updated
July 18, 2025
Certified
July 18, 2025
Sole proprietor
No

Specialties & taxonomy codes

TaxonomyCodeLicenseState
General Practice Dentistry Primary 1223G0001X 61691554 WA

Mailing address

12115 19TH Ave SE Apt H303
Everett, WA 98208-6277
Phone
(425) 207-6827

About Dr. Park

Derek Park, DDS is a healthcare provider registered in the NPI registry with the primary taxonomy General Practice Dentistry (code 1223G0001X). The practice location is 623 W Main St, Monroe, WA 98272-2101. The NPI number 1700778172 was assigned on July 18, 2025 and the record was last updated on July 18, 2025.

Dr. Park lists a license in the registry: #61691554 (WA) for General Practice Dentistry. License numbers are self-reported to NPPES; verify them with the state licensing board.

Frequently asked questions

What is the NPI number of Derek Park, DDS?

The NPI number is 1700778172.

What is the phone number of Dr. Park?

The phone number listed for the practice location is (360) 805-9060.

Where is Dr. Park located?

623 W Main St, Monroe, WA 98272-2101.

What is the taxonomy code for Dr. Park?

The primary taxonomy code is 1223G0001X – General Practice Dentistry.

Is this information correct?

All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.

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