Doctor profile · Federal record
Dr. Etern Park, DDS, MD
Oral and Maxillofacial Surgery (Dentist) (CMS: Oral Surgery) · Oral and Maxillofacial Surgery (Dentist) · Oral and Maxillofacial Surgery (Dentist) · Oral and Maxillofacial Surgery (Dentist) · Oral & Maxillofacial Surgery (D.M.D.) · Oral & Maxillofacial Surgery (D.M.D.) · Fargo, ND
- NPI 1124289905
- Accepts Medicare
- 18 yrs in practice
- Licensed in 3 states
- Male
- Group practice
- No sanctions
Practice & contact
- Primary practice
-
1717 University Dr S
Fargo, ND 581034939
(701) 234-2000 - Mailing address
-
Po Box 5074
Sioux Falls, SD 571175074
Credentials & registration
- NPI registered
- June 2008 — 18 yrs on file
- Profile last updated
- February 11, 2025
- Year of graduation
- 2008 — 18 yrs since
- Specialty taxonomy
- 1223S0112X — NUCC code
- State licenses (6)
- New York #053210 · North Dakota #2503 · Delaware #C1-0011804 · Delaware #G3-0000458 · North Dakota #21037 · New York #269333
Federal sanctions & exclusions
No sanctions, exclusions or revocations on file
Checked against OIG LEIE on NPI 1124289905. Last verified May 11, 2026.Medicare procedures · 2023
Top services delivered
Total services
164
Distinct HCPCS
4
Medicare allowed
$8,828
| HCPCS | Description | Services | Patients | Avg allowed | |
|---|---|---|---|---|---|
99213 |
Established patient office or other outpatient visit, 20-29 minutes | 77 | 51 | $64 | |
99202 |
New patient office or other outpatient visit, 15-29 minutes | 59 | 59 | $48 | |
99212 |
Established patient office or other outpatient visit, 10-19 minutes | 16 | 16 | $36 | |
92511 |
Exam of the nose and throat using an endoscope | 12 | 11 | $38 |
In context: peer comparison
Among 2 peers in Fargo Oral and Maxillofacial Surgery (Dentist), average services per provider: 32. This provider delivers 5.1× the peer median.Open Payments
Industry payments received
All-time total
$93
Transactions
4
Manufacturers
3
| Payer (manufacturer) | Industry | Txns | Amount |
|---|---|---|---|
| DePuy Synthes Sales INC. | 1 | $32.57 | |
| Medical Device Business Services, INC. | 2 | $31.26 | |
| Kls-Martin L.P. | 1 | $29.48 |
By nature of payment
Hospital affiliations
Frequently asked questions
What is Dr. Etern Park's medical specialty?
Dr. Etern Park practices Oral and Maxillofacial Surgery (Dentist) in Fargo, ND.
Where does Dr. Etern Park practice?
Dr. Etern Park practices at 1717 University Dr S, Fargo, ND 581034939. Office phone: 7012342000.
What is Dr. Etern Park's NPI?
Dr. Etern Park's National Provider Identifier (NPI) is 1124289905, issued by NPPES.
Does Dr. Etern Park accept Medicare assignment?
Yes. Dr. Etern Park accepts Medicare assignment, meaning Medicare-allowed amounts are accepted as full payment for covered services.
What procedures does Dr. Etern Park commonly perform?
Top Medicare-reported procedures in 2023: Established patient office or other outpatient visit (HCPCS 99213); New patient office or other outpatient visit (HCPCS 99202); Established patient office or other outpatient visit (HCPCS 99212). Source: CMS Medicare Physician & Other Practitioners file.