Kang-Woo Daniel Park, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

22DI02997300 Issued in NJ

Practice address

83 Park St
Montclair, NJ 07042-3465

Phone

(973) 744-0881

NPI assigned

Apr 3, 2019

Sex

Male

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1554249600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746403200000",
    "number": "1063974459",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "83 PARK ST",
            "city": "MONTCLAIR",
            "state": "NJ",
            "postal_code": "070423465",
            "telephone_number": "973-744-0881"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "83 PARK ST",
            "city": "MONTCLAIR",
            "state": "NJ",
            "postal_code": "070423465",
            "telephone_number": "973-744-0881"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "30 E 37th St",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100163019",
            "country_code": "US",
            "telephone_number": "646-727-4188",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PARK",
        "first_name": "KANG-WOO",
        "middle_name": "DANIEL",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-04-03",
        "last_updated": "2025-05-05",
        "certification_date": "2025-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "061329",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NJ",
            "license": "22DI02997300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jacy Papasikos, D.M.D
• Nicholas Papouchis, PH.D., ABPP
• Parabolic Performance & Rehab, LLC
• Susan C. Parente, PSY.D.
• Chong H Park, M.D., F.R.C.S.(US)
• Carol B Parker, LCSW
• Mario Parker
• Jessica A Parks, OTR
• Lissa Parsonnet, PHD
• Steven Pasterick, PT, DPT

• Dentist in Montclair, NJ
• Providers in Montclair, NJ by specialty
• Dentist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 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.