Active NPI
Woo Jin Park, D.M.D.
- Dentist
- Seattle, WA
National Provider Identifier
1023547130
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- DE60867854
- Practice address
- 10521 Meridian Ave N
Seattle, WA 98133 - Phone
- (206) 296-4990
- Fax
- (206) 205-5142
- NPI assigned
- Jun 12, 2017
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | DE60867854 | WA | Primary |
Addresses
Primary practice location
10521 Meridian Ave N
Seattle, WA 98133
Mailing address
1200 12TH Avenue South
Suite 901
Seattle, WA 98144
Phone (206) 548-3114
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Interoperability endpoints
- wpark299594@direct.ochin.org
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1497225600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1531094400000",
"number": "1023547130",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1200 12TH AVENUE SOUTH",
"address_2": "SUITE 901",
"city": "SEATTLE",
"state": "WA",
"postal_code": "98144",
"telephone_number": "206-548-3114",
"fax_number": "206-762-6355"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10521 MERIDIAN AVE N",
"city": "SEATTLE",
"state": "WA",
"postal_code": "98133",
"telephone_number": "206-296-4990",
"fax_number": "206-205-5142"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PARK",
"first_name": "WOO JIN",
"name_prefix": "Dr.",
"credential": "D.M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-06-12",
"last_updated": "2018-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "WA",
"license": "DE60867854",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Seattle, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.