Paul Jahng Park, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

8119 Issued in NV

Practice address

2560 Montessouri St Ste 109
Las Vegas, NV 89117-3063

Phone

(702) 362-9353

NPI assigned

Aug 9, 2024

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Paul J. Park PLLC

  • Dental Clinic/Center
  • Las Vegas, NV
  • NPI 1518852755
  NPD Authorized official
• Chad N Gubler DDS Casino Direct LTD

  • Dentist
  • Las Vegas, NV
  • NPI 1548084759
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1723161600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749513600000",
    "number": "1033940374",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3185 S SEPULVEDA BLVD APT 101",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900344221",
            "telephone_number": "424-402-2933"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2560 MONTESSOURI ST STE 109",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891173063",
            "telephone_number": "702-362-9353"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "PAUL",
        "middle_name": "JAHNG",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-08-09",
        "last_updated": "2025-06-10",
        "certification_date": "2025-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NV",
            "license": "8119",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Min Soo Park, D.O.
• Miranda Alexis Park
• Nam Hoon Park, MD
• Nathania Louise Park, FNP-BC
• Ok Jin Park
• Peter Park, O.D.
• Romy Park, O.D.
• Rustin Jin Park, RN, BSN
• Sarah Park, APRN
• Sehoon Park, MD

• General Practice Dentistry in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• General Practice Dentistry in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.