NPIMap

Organization Active NPI

Hyun S. Park DDS, PS

Doing business as Northwest Dentistry

  • Dentist
  • Federal Way, WA
National Provider Identifier
1104150473
Registry record updated Sep 19, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DE7278 Issued in WA
Legal business name
HYUN S. PARK DDS, PS
Doing business as
Northwest Dentistry
Practice address
1717 S 324TH St Ste a
Federal Way, WA 98003-8500
Phone
(253) 815-0093
NPI assigned
Sep 19, 2009
Last updated
Sep 19, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2009

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

Authorized official

Name
Dr. Hyun S Park, DDSNPI 1689682189
Title
President
Phone
(253) 815-0093

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X DE7278 WA Primary

Addresses

Primary practice location

1717 S 324TH St Ste a
Federal Way, WA 98003-8500

Mailing address

1717 S 324TH St Ste a
Federal Way, WA 98003-8500
Phone (253) 815-0093

Other names 1

  • Northwest Dentistry Doing business as

National Provider Directory

National Provider Directory

Locations

1717 S 324th St
Ste A
Federal Way, WA 98003
Phone (253) 815-0093

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1253318400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1253318400000",
    "number": "1104150473",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1717 S 324TH ST STE A",
            "city": "FEDERAL WAY",
            "state": "WA",
            "postal_code": "980038500",
            "telephone_number": "253-815-0093"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1717 S 324TH ST STE A",
            "city": "FEDERAL WAY",
            "state": "WA",
            "postal_code": "980038500",
            "telephone_number": "253-815-0093"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HYUN S. PARK DDS, PS",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-09-19",
        "last_updated": "2009-09-19",
        "status": "A",
        "authorized_official_last_name": "PARK",
        "authorized_official_first_name": "HYUN",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "253-815-0093",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "WA",
            "license": "DE7278",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Northwest Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Federal Way, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2009; 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.