NPI age
13 years
Enumerated 2012-10-29
● Active
Type 1 · Individual
DR. Kony Park, D.M.D
Park is 1 of 5 dentist providers in Georgetown and 1 of 650 in Texas.
Primary specialty
Dentist
Licensed in
TX
1 state
Status
Active
No deactivations on record
Last NPPES update
2024-01-16
Source: monthly bulk 2026-05
Sole proprietor
No
May be part of a larger org
How this provider compares
Across 650 active dentist providers in Texas.
NPI age
13 years
↓ 3 yr below median (16 yr)
State licenses
1 state
15% of peers hold multiple states
Subspecialties
0
24% of peers hold subspecialties
NPI lifetime · 2012 → 2026
2012-10Enumerated in NPPES
2012
2026
Where they practice
Practice location
4913 Moreland Dr Ste 103
Georgetown, TX 786335509
Mailing address
30102 Diamond Dove Trl
Georgetown, TX 786283724
Specialties
-
Dentist PrimaryThe 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...
Practice context
Solo or small practice. No other active providers share this practice address in NPPES.
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- Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
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