Doctor profile · Federal record

Dr. Samuel Park, DMD

Dentist · Tinker Afb, OK

  • NPI 1609448646
  • 5 yrs on file
  • Male
  • Group practice
  • No sanctions

Practice & contact

Operates at 2 locations .

NPPES Updated May 11, 2026
Primary practice
7050 Air Depot Blvd Bldg 1094
Tinker Afb, OK 731458716
(954) 290-7165
Additional location
76 Nealy Blvd Bldg 92
Hampton, VA 236652022
(757) 225-7630
Mailing address
5306 Tractor Ln
Fairfax, VA 220307239

Credentials & registration

NPPES · NUCC
NPI registered
July 2021 — 5 yrs on file
Profile last updated
November 24, 2024
Specialty taxonomy
122300000X — NUCC code
State license (1)
Virginia #0401417587

Federal sanctions & exclusions

OIG LEIE Updated May 11, 2026

No sanctions, exclusions or revocations on file

Checked against OIG LEIE on NPI 1609448646. Last verified May 11, 2026.

Open Payments

Industry payments received

CMS Open Payments
All-time total
$25
Transactions
1
Manufacturers
1
Payer (manufacturer) Industry Txns Amount
Dentsply Sirona INC 1 $24.81

By nature of payment

Food and Beverage
$25

Frequently asked questions

Auto-generated from federal data
What is Dr. Samuel Park's medical specialty?
Dr. Samuel Park practices Dentist in Tinker Afb, OK.
Where does Dr. Samuel Park practice?
Dr. Samuel Park practices at 7050 Air Depot Blvd Bldg 1094, Tinker Afb, OK 731458716. Office phone: 9542907165.
What is Dr. Samuel Park's NPI?
Dr. Samuel Park's National Provider Identifier (NPI) is 1609448646, issued by NPPES.