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Dr. Samuel Park , DMD

Dentist β€’ Tinker Afb, OK

Active NPI 1609448646 Individual Practitioner Male Practitioner
Practice location in NPPES

7050 Air Depot Blvd Bldg 1094
Tinker Afb, OK 731458716

Call 9542907165 Location details and other listings
Medical Disclaimer

This profile restates public CMS/NPPES data; T-MedInfo gives no medical advice — consult a licensed professional, and call 911 for emergencies.

Practice Location & Contact Primary Location

Practice Address

7050 Air Depot Blvd Bldg 1094

Tinker Afb, OK 731458716

Telephone 9542907165
Other Listings in Public Data

NPPES lists 1 additional practice-address record in Hampton, VA. See the list

Source: CMS NPPES NPI Registry, practice location records; release date unavailable.

Listings do not confirm current availability, employment or a shared ownership network.

Industry payments (Open Payments)

Fewer than 11 payment records totaling $24.81 in 2024

Drug and medical device companies must report certain payments to doctors and some other clinicians to CMS, such as meals, travel, speaking fees or research funding.

These records are submitted by drug and medical device companies, and a reported payment does not necessarily mean the financial relationship is improper.

General: payments not tied to research, such as meals, travel, consulting or speaking fees.

A reported payment does not necessarily mean the financial relationship is improper. Research payments can go to a hospital or university for a study the clinician leads, not to the clinician personally. Clinicians can dispute records with the company that reported them.

Source: CMS Open Payments, program year 2024.

Guide: How to read an Open Payments record

NPI first issued

2021

The year this clinician's National Provider Identifier (NPI) was issued. An NPI is a unique 10-digit ID that US health care providers use for billing.

What this does not show: NPI first issued

NPIs have been issued only since 2005, so this year is not necessarily when the clinician started practicing.

Source: CMS NPPES NPI Registry.

Medicare assignment not listed

CMS data do not show whether this clinician accepts Medicare assignment. This does not mean they do not accept Medicare. Ask the office.

Medicare assignment applies to Original Medicare. It does not tell you whether the clinician is in a Medicare Advantage plan's network, accepts other insurance, or is taking new patients.

Source: CMS Doctors and Clinicians; Medicare.gov, β€œDoes your provider accept Medicare as full payment?”

Guide: What Medicare assignment means

No telehealth indicator

CMS shows this indicator only when recent Medicare claims include telehealth services. The clinician may still offer telehealth; ask the office.

Source: CMS, Telehealth Indicator on Medicare Care Compare (fact sheet, January 2023); CMS Doctors and Clinicians.

Guide: How Medicare covers telehealth

Compared with the same specialty in Tinker Afb and Oklahoma

9 active clinicians are listed under Dentist with a practice address in Tinker Afb, OK (1,059 in Oklahoma).

Addresses are self-reported to NPPES and may be out of date.

Sources: CMS Open Payments (2024), CMS Doctors and Clinicians, CMS NPPES NPI Registry. Specialty names follow the NUCC Health Care Provider Taxonomy.

Text: T-MedInfo Β· Report an error.

Pharma & Medical Device Financial Disclosures

Payments and other transfers of value that drug and medical device companies reported to CMS Open Payments

Open Payments Β· Program Year 2024

Program year 2024 (payments made January 1 – December 31, 2024): fewer than 11 records totaling $24.81.

Manufacturer Payment Nature Product Type Amount ($)
Dentsply Sirona Inc
Food and Beverage
In-kind items and services
SureSmile General $24.81

Source: CMS Open Payments, program year 2024, released June 30, 2026.

Specialties & License Numbers Reported to NPPES

Self-certified to NPPES: 2024-11-24
Dentist Primary Specialty

NUCC Taxonomy Code: 122300000X

License # reported to NPPES VA 0401417587

A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist.

Check License Status with the State Board License numbers are self-reported to NPPES; T-MedInfo does not confirm them against state records. Current status: Oklahoma State Board of Medical Licensure.
Look Up on State Board Site

Secondary Practice Locations

76 Nealy Blvd Bldg 92

Hampton, VA 236652022

Phone: 7572257630

Clinicians Sharing This Practice Address or Phone

Clinicians sharing this NPPES address, phone or fax; a shared contact does not mean they work together.

3 listed
Kristen Janssen , PA

Physician Assistant

NPI 1982679130

Physician Assistant

Dr. Joel Kraft , MD

Family Medicine

NPI 1629365572

Doctor of Medicine (M.D.)

Dr. Nathaniel Rosol , MD

Military Health Care Provider

NPI 1598221434

Doctor of Medicine (M.D.)

Career & Practice History Timeline

Changes recorded in monthly NPPES data files: addresses, names, credentials, specialties and NPI status

8 Historical Events
πŸ“
Updated Practice Location November 24, 2024

Registered at 7050 AIR DEPOT BLVD BLDG 1094, TINKER AFB, OK 731458716 (Tel: 9542907165)

πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) November 24, 2024

Dentist (license number reported to NPPES: VA 0401417587)

βœ…
NPI Profile Active July 10, 2021

NPI status registered as active in NPPES database

πŸ“
Practice Location (Initial Record) July 10, 2021

Registered at 76 NEALY BLVD BLDG 92, HAMPTON, VA 236652022 (Tel: 7572257630)

πŸ“
Business Mailing Address (Initial Record) July 10, 2021

Registered at 5306 TRACTOR LN, FAIRFAX, VA 220307239 (Tel: 9542907165)

πŸ‘€
Provider Name / Credentials (Initial Record) July 10, 2021

Recorded as SAMUEL PARK, DMD

πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) July 10, 2021

Student in an Organized Health Care Education/Training Program

🟒
Initial NPI Registration & Enumeration July 10, 2021

First registered as active Individual Practitioner in NPPES Database.

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NPI Administrative Meta

NPI Number: 1609448646
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: July 10, 2021
Last Update: November 24, 2024
Sole Proprietor: No

Other Dentists in Tinker Afb

Mailing Address

5306 Tractor Ln

Fairfax, VA 220307239

Phone: 9542907165

About This Data NPPES fields (address, phone, specialty, license) are self-reported and may be outdated; Medicare fields follow the CMS dataset named in each section. Correct directly at NPPES.