Etern S. Park, DDS, MD
Oral and Maxillofacial Surgery (Dentist) · Fargo, ND
Etern S. Park, DDS, MD is an oral and maxillofacial surgery (dentist) with a practice address in Fargo, North Dakota, and NPI 1124289905, issued on Jun 24, 2008. Check the license (North Dakota 21037, as entered in NPPES) with the North Dakota board that licenses this profession; the Medicare figures below come from public CMS files.
- Name
- Etern S. Park
- Credential
- DDS, MD
- Primary taxonomy
- Oral and Maxillofacial Surgery (Dentist) 1223S0112X
- License numbers
- 21037 ND
2503 ND
053210 NY
C1-0011804 DE
G3-0000458 DE
and 1 more
Self-reported in NPPES; status is on the state search - Practice location
- 1717 University Dr S, Fargo, ND 58103
- Phone
- (701) 234-2000
- Enumerated
- Jun 24, 2008
- Record last updated
- Feb 11, 2025
- Medicare enrollment
- Enrolled (PECOS I20240813003978); accepts Medicare assignment
- Entity
- Type 1 · individual
8 nearest oral and maxillofacial surgery (dentist) records → All 23 in North Dakota → Look up another NPI →
Also registered at 1717 University Dr S
A shared address usually means a shared clinic or building; it does not show who employs whom.
- David Anderson, MD, PHARMDOphthalmology Physician1912328014
- Steven Anderson, M.D.Ophthalmology Physician1518991678
- Katayoon Baradaran Ebrahimi, M.D.Ophthalmology Physician1104282359
- William Boggess, D.M.D., M.D.Oral & Maxillofacial Surgery (D.M.D.)1588962781
- Sugong Chen, M.D.Surgery Physician1487972972
- Leann Czapiewski, LRDRegistered Dietitian1598262545
Verify Etern S. Park in five checks
- 1IdentityNPI record in CMS NPPESNPI lookupConfirmed in NPPES
- 2LicenseActive license and public ordersWhich North Dakota board licenses this profession
Search for license 21037Check the board - 3Other statesLicenses and actions elsewhereDocInfo (FSMB)Not checked
- 4ExclusionsMedicare and Medicaid bansHHS-OIG exclusion listNot checked
- 5CertificationBoard certificationABMS AOA NCCPA AANPNot checked
Industry payments in 2024: $93.31
4 payments; by number, the most common kind was food and beverage; the largest payer was DePuy Synthes Sales Inc. The 4,075 providers of this specialty with any payment received $1,077.58 on average. Payments are reported by manufacturers, not by the provider, and are not a sign of wrongdoing.
Source: CMS Open Payments, program year 2024 (openpaymentsdata.cms.gov); average among providers of this specialty with at least one payment.
One hospital affiliation
- Sanford Medical Center FargoWest Fargo, ND · Acute Care Hospitals4 of 5 stars
Source: CMS Doctors and Clinicians National Downloadable File (the group practices a clinician bills Medicare through); hospitals matched to CMS Hospital General Information (Care Compare) (data.cms.gov). Star ratings are CMS hospital ratings, not ratings of this provider.
Etern S. Park among 23 oral and maxillofacial surgery (dentist) records in North Dakota
Etern S. Park, DDS, MD is one of 23 oral and maxillofacial surgery (dentist) records with a practice address in North Dakota. 74% of them appear in a Medicare file (Part D prescribing, MIPS, Open Payments or Medicare group billing); this one does. Its NPI, issued in 2008, is newer than 91% of them.
- NPI issued2008 · 91% of these records are older, 4% newer
- In a Medicare fileYes · 74% of these records are
- In the CMS Doctors and Clinicians fileYes · 48% of these records are
- Graduated2008 · median 2003 among the 11 with a school on file
- Record last updated2025 · 78% of these records were not updated in five years or more
Source: CMS NPPES, file of Aug 9, 2026, every record with primary taxonomy 1223S0112X and a North Dakota practice address; Medicare files: CMS Part D Prescribers 2024, MIPS 2023, Open Payments 2024, Doctors and Clinicians (data.cms.gov).
Oral and Maxillofacial Surgery (Dentist) providers in North Dakota
There are 23 oral and maxillofacial surgery (dentist) records in North Dakota.
All 23 in North Dakota → Every provider in Fargo → Oral and Maxillofacial Surgery (Dentist) nationwide →
The 8 oral and maxillofacial surgery (dentist) records with the nearest ZIP codes
- Charles Crago, DMD, MDFargo, ND 581031629147723
- Jonathan Gray, DDSFargo, ND 581031508048521
- Paul Iverson, DDSFargo, ND 581031467487298
- Frank Newman, D.M.D.Fargo, ND 581031548454085
- Scott Preisler, DDS, MSFargo, ND 581031780761031
- Ryan Smart, DMDFargo, ND 581031386849446
- Cody JordanFargo, ND 581041043847874
- Michael Noffze, DDSFargo, ND 581041538147848
Common questions
What is Etern S. Park, DDS, MD's NPI number?
Etern S. Park, DDS, MD's National Provider Identifier (NPI) is 1124289905, issued on Jun 24, 2008. An NPI identifies a provider in billing; it is not a license.
Where is Etern S. Park, DDS, MD located?
The NPPES record lists a practice address at 1717 University Dr S, Fargo, ND, 58103. Phone: (701) 234-2000. Providers update this record themselves, so call before visiting.
How can I verify Etern S. Park, DDS, MD's license?
NPPES lists North Dakota license number 21037, as entered by the provider. Search the North Dakota board that licenses this profession; the NPPES record confirms identity only.
Source: CMS National Plan and Provider Enumeration System (NPPES), file of Aug 9, 2026 (NPPES files on CMS.gov); NUCC Health Care Provider Taxonomy. Medicare files from data.cms.gov. An NPI identifies who bills; it is not a license.
Figures on PlainDoctor are read from the federal files each page names (CMS NPPES, Medicare Part D, MIPS, Open Payments; the HHS-OIG exclusion list only as counts) and from Census population estimates, with the file date shown beside them. See our editorial standards & corrections policy, the methodology behind these numbers, or report a data error. Data current as of Aug 9, 2026.