NPI age
15 years
Enumerated 2010-10-24
● Active Type 2 · Organization
Park Pediatric Dentistry Of Woodstock, Llc
Park Pediatric Dentistry Of Woodstock, Llc is 1 of 539 dentist organizations in Georgia.
Primary specialty
Dentist
Practice locations
1
0 secondary on file
Status
Active
No deactivations on record
Authorized official
Park
Ceo
Last NPPES update
2010-10-24
Source: monthly bulk 2026-05
How this organization compares
Across 539 active dentist providers in Georgia.
NPI age
15 years
≈ at median (16 yr)
Practice locations
1
0 secondary on file
Subspecialties
0
NPI lifetime · 2010 → 2026
2010-10Enumerated in NPPES
2010
2026
Where they practice
Primary practice location
1816 Eagle Dr, Suite 200-C
Woodstock, GA 301898272
Mailing address
1816 Eagle Dr, Suite 200-C
Woodstock, GA 301898272
Authorized official
Julius Park, DMD
Ceo
📞 7709269260
Individual providers at this organization
5 individual providers on file at this primary practice address.
- Ryan Dye, PTA Physical Therapy Assistant NPI 1013887025
- Scott Harden, D.D.S. Dentist NPI 1538210695
- Richard Manrique, MD General Practice NPI 1548299332
- Julius Park, D.M.D. Dentist NPI 1710022942
- Robert Riesing, PT,DPT Physical Therapist NPI 1336420017
Specialties
-
Dentist PrimaryAn age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs.
Practice context
Multi-provider organization. 5 individual providers on file at this primary address.
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- Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
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- Confirm payer enrollment if billing.NPI presence does not guarantee active enrollment with Medicare, Medicaid, or commercial payers.