NPIMap

Organization Active NPI

Sunmin Park, D.D.S.

  • General Practice Dentistry
  • MC Lean, VA
National Provider Identifier
1043561988
Registry record updated Oct 1, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
0401008699 Issued in VA
Legal business name
SUNMIN PARK, D.D.S.
Practice address
1515 Chain Bridge Rd
#304
MC Lean, VA 22101-4451
Phone
(703) 821-0080
NPI assigned
Oct 1, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 1, 2012

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

Authorized official

Name
Dr. Sunmin Park, D.D.S.
Title
President
Phone
(703) 821-0080

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 0401008699 VA Primary

Addresses

Primary practice location

1515 Chain Bridge Rd
#304
MC Lean, VA 22101-4451

Mailing address

1515 Chain Bridge Rd
#304
MC Lean, VA 22101-4451
Phone (703) 821-0080

Other names 1

  • Mclean Family & Cosmetic dentistry Doing business as

National Provider Directory

National Provider Directory

Locations

1515 Chain Bridge Rd
#304
Mc Lean, VA 22101
Phone (703) 821-0080

NPI Registry JSON

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

{
    "created_epoch": "1349049600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1349049600000",
    "number": "1043561988",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1515 CHAIN BRIDGE RD",
            "address_2": "#304",
            "city": "MC LEAN",
            "state": "VA",
            "postal_code": "221014451",
            "telephone_number": "703-821-0080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1515 CHAIN BRIDGE RD",
            "address_2": "#304",
            "city": "MC LEAN",
            "state": "VA",
            "postal_code": "221014451",
            "telephone_number": "703-821-0080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUNMIN PARK, D.D.S.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-10-01",
        "last_updated": "2012-10-01",
        "status": "A",
        "authorized_official_last_name": "PARK",
        "authorized_official_first_name": "SUNMIN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "703-821-0080",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "VA",
            "license": "0401008699",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mclean Family & Cosmetic dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in MC Lean, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2012; 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.