Provider Demographics
NPI:1912883992
Name:THUNDERCAT PEDIATRIC DENTISTRY PLLC
Entity type:Organization
Organization Name:THUNDERCAT PEDIATRIC DENTISTRY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SIHYUN
Authorized Official - Middle Name:
Authorized Official - Last Name:PARK
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:917-854-1510
Mailing Address - Street 1:21 INDIA ST UNIT PHE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11222-7300
Mailing Address - Country:US
Mailing Address - Phone:917-854-1510
Mailing Address - Fax:
Practice Address - Street 1:211 MCGUINNESS BLVD
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11222-6787
Practice Address - Country:US
Practice Address - Phone:718-344-3748
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-08-14
Last Update Date:2025-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental