Jimin Park-Reeves, D.M.D.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DE60437962 Issued in WA

Practice address

655 W Smith St Ste 206
Kent, WA 98032

Phone

(253) 854-8306

NPI assigned

Aug 22, 2011

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Justin C Courtney DDS PLLC

  • Dental Clinic/Center
  • Kent, WA
  • NPI 1770230880
  NPD (past)

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

{
    "created_epoch": "1313971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1535587200000",
    "number": "1063792000",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7608 113TH AVE SE",
            "city": "NEWCASTLE",
            "state": "WA",
            "postal_code": "980561664",
            "telephone_number": "512-461-2182"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "655 W SMITH ST STE 206",
            "city": "KENT",
            "state": "WA",
            "postal_code": "98032",
            "telephone_number": "253-854-8306"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "24040 SE Kent Kangley Rd",
            "address_purpose": "LOCATION",
            "city": "Maple Valley",
            "state": "WA",
            "postal_code": "980386930",
            "country_code": "US",
            "telephone_number": "425-578-9152",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PARK-REEVES",
        "first_name": "JIMIN",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-08-22",
        "last_updated": "2018-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WA",
            "license": "60437962",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WA",
            "license": "DE60437962",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Paradise Med Care LLC
• Frances Pardillo, MSW, LSWAIC
• Eve Paretsky, M.D.
• Divya Parihar, M.D
• Park Kent Dental and Denture LLP
• Alcina J Park, DOT
• Hosan Park, D.D.S
• Paul Park
• Arkar Parker, AAC
• C Bruce Parker

• General Practice Dentistry in Kent, WA
• Providers in Kent, WA by specialty
• General Practice Dentistry in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.