Active NPI
Hye Yang Park, DDS
- General Practice Dentistry
- Albany, NY
National Provider Identifier
1063796373
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 055378
- Practice address
- 1873 Western Ave
Suite 200
Albany, NY 12203-5028 - Phone
- (518) 869-1044
- Fax
- (518) 869-1965
- NPI assigned
- Oct 5, 2011
- Sex
- Female
- 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 |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 055378 | NY | Primary |
Addresses
Primary practice location
1873 Western Ave
Suite 200
Albany, NY 12203-5028
Mailing address
1873 Western Ave
Suite 200
Albany, NY 12203-5028
Phone (518) 869-1044
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 055378 | Other | NY | NEW YORK STATE LICENSE |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 055378 | NY | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Group Health Incorporated | Past | Accepting new patients | |
| Emblemhealth Medical and Dental Services Inc. | Past | Accepting new patients |
Organizations & group practices 2
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.
-
dba GHI Family Dental Practice/OEHC
- Health Service Clinic/Center
- Albany, NY
- NPI 1275823734
-
dba GHI Family Dental Practice
- Dental Clinic/Center
- Albany, NY
- NPI 1629175831
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1317772800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1317772800000",
"number": "1063796373",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1873 WESTERN AVE",
"address_2": "SUITE 200",
"city": "ALBANY",
"state": "NY",
"postal_code": "122035028",
"telephone_number": "518-869-1044",
"fax_number": "518-869-1965"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1873 WESTERN AVE",
"address_2": "SUITE 200",
"city": "ALBANY",
"state": "NY",
"postal_code": "122035028",
"telephone_number": "518-869-1044",
"fax_number": "518-869-1965"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PARK",
"first_name": "HYE",
"middle_name": "YANG",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-10-05",
"last_updated": "2011-10-05",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "NY",
"license": "055378",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NEW YORK STATE LICENSE",
"identifier": "055378",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Albany, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.