Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Dr. Earl P Park, DMDMD

Individual provider Oral and Maxillofacial Surgery (Dentist) · NPI 1558659698

Dr. Earl P Park, DMDMD is a Maxillofacial Surgery in Birmingham, Alabama. Qualified in 2014, 12 years ago. Practices with Louisiana State University School of Medicine in New Orleans Faculty G, a 447-clinician group and accepts Medicare assignment. Licensed in Alabama and Louisiana.

Years since qualifying
12
Licensed in
AL, LA
In the registry since
2011
Specialties on file
2
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Practice location Address checks out

2000 6th Ave S
Birmingham, AL 35233-2110
Phone: (205) 934-9999
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Oral & Maxillofacial Surgery (D.M.D.) (primary) Taxonomy 204E00000X · Licence 35601 (AL)
Oral and Maxillofacial Surgery (Dentist) Taxonomy 1223S0112X · Licence RESTRICTED (LA)

Record details

NPI number1558659698
Entity typeIndividual (Type 1)
GenderMale
Credentials DMDMD
Sole proprietorYes
NPI enumeratedJuly 11, 2011
Last updated in NPPESJuly 21, 2022
Mailing addressPo Box 55310, Birmingham, AL 35255-5310

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyMAXILLOFACIAL SURGERY
Medical schoolOTHER
Graduated 2014 (12 years in practice)
Group practice Louisiana State University School Of Medicine In New Orleans Faculty G — 447 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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