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Dr. Tracey Park , DDS

Dentist β€’ Puyallup, WA

Active NPI 1104306729 Individual Practitioner Female Practitioner
Practice location in NPPES

702 S Hill Park Dr Ste 201
Puyallup, WA 983731426

Call 8554336825 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

702 S Hill Park Dr Ste 201

Puyallup, WA 983731426

Telephone 8554336825
Organization at the Same NPPES Address or Phone
Willamette Dental Facility NPI 1194143065

Matched by practice address or phone in NPPES. A shared address or phone does not confirm that this clinician works there.

Other Listings in Public Data

NPPES lists 2 distinct additional practice-address records in Federal Way, WA; Kent, WA. 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)

No Open Payments records are listed for this clinician for 2019–2025.

Guide: How to read an Open Payments record

NPI first issued

2018

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

Enrolled in Medicare (PECOS)

Dr. Park has a Medicare enrollment record in PECOS, the CMS system clinicians use to enroll so they can bill Medicare or order services for people with Medicare.

It does not show whether the clinician accepts assignment, is in your plan's network, or is taking new patients.

Source: CMS Medicare Fee-For-Service Public Provider Enrollment (PECOS); CMS Order and Referring file.

Guide: What Medicare enrollment (PECOS) means

Can order Medicare-covered services

CMS lists Dr. Park as eligible to order or refer Medicare Part B clinical laboratory and imaging services, durable medical equipment (DME) and home health services for people with Medicare.

What this does not show: Can order Medicare-covered services

It does not mean the clinician offers these services directly.

Source: CMS Medicare Fee-For-Service Public Provider Enrollment (PECOS); CMS Order and Referring file.

Guide: What ordering and referring status means

Compared with the same specialty in Puyallup and Washington

71 active clinicians are listed under Dentist with a practice address in Puyallup, WA (2,768 in Washington).

Addresses are self-reported to NPPES and may be out of date.

Telehealth indicator in Puyallup

0% of these 71 clinicians have the CMS telehealth indicator.

0% of these 71 clinicians are listed by CMS as accepting Medicare assignment.

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

Text: T-MedInfo Β· Report an error.

Specialties & License Numbers Reported to NPPES

Self-certified to NPPES: 2023-11-07
Dentist Primary Specialty

NUCC Taxonomy Code: 122300000X

License # reported to NPPES WA DE60879733

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: Washington State Department of Health Provider Lookup.
Look Up on State Board Site

Medicare (PECOS) Enrollment & Ordering Eligibility

Source: CMS PECOS
Medicare FFS Enrollment Status Medicare Enrollment on File
CMS Provider Specialty

ORDER AND REFERRING ONLY - DENTIST

Medicare Enrollment ID

I20181004002984

Enrollment State Jurisdiction

WA

PECOS Control ID

9133471915

Medicare Order & Referring Eligibility
Clinical Lab & Imaging (Part B) Eligible
Durable Medical Equipment (DME) Eligible
Home Health Agency (HHA) Eligible
Power Mobility Devices (PMD) Not Eligible

Sources: CMS Provider Enrollment and Order and Referring. Medicare enrollment is a billing status, not an accreditation or quality rating.

Secondary Practice Locations

181 S 333rd St Ste 100

Federal Way, WA 98003

Phone: 8554336825

510 Washington Ave N

Kent, WA 980324453

Phone: 8554336825

Clinicians Sharing This Practice Address or Phone

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

22 listed
Dr. Eric Alston , DMD

Dentist - General Practice

NPI 1194165878

Doctor of Dental Medicine

NPI 1124530043

Doctor of Dental Surgery

NPI 1033464524

Doctor of Dental Medicine

Dr. Thao Chu , DDS

Dentist - General Practice

NPI 1033213657

Doctor of Dental Surgery

Dr. Elisabeth Gorman , DMD

Dentist - General Practice

NPI 1063988558

Doctor of Dental Medicine

NPI 1053818625

Doctor of Dental Surgery

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 07, 2023

Registered at 702 S HILL PARK DR STE 201, PUYALLUP, WA 983731426 (Tel: 8554336825)

πŸ“
Updated Practice Location April 29, 2019

Registered at 510 WASHINGTON AVE N, KENT, WA 980324453 (Tel: 8554336825)

βœ…
NPI Profile Active August 15, 2018

NPI status registered as active in NPPES database

πŸ“
Practice Location (Initial Record) August 15, 2018

Registered at 181 S 333RD ST STE 100, FEDERAL WAY, WA 98003 (Tel: 8554336825)

πŸ“
Business Mailing Address (Initial Record) August 15, 2018

Registered at 6950 NE CAMPUS WAY, HILLSBORO, OR 971245611 (Tel: 8554336825)

πŸ‘€
Provider Name / Credentials (Initial Record) August 15, 2018

Recorded as TRACEY PARK, DDS

πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) August 15, 2018

Dentist (license number reported to NPPES: WA DE60879733)

🟒
Initial NPI Registration & Enumeration August 14, 2018

First registered as active Individual Practitioner in NPPES Database.

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NPI Administrative Meta

NPI Number: 1104306729
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: August 14, 2018
Last Update: November 07, 2023
Sole Proprietor: No

Other Dentists in Puyallup

All Dentists in Puyallup

Mailing Address

6950 Ne Campus Way

Hillsboro, OR 971245611

Phone: 8554336825

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.