Hosan Park, D.D.S

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

DE60722033 Issued in WA

Practice address

25610 104TH Ave SE
Kent, WA 98030-7610

Phone

(253) 850-9777

NPI assigned

Jan 30, 2017

Sex

Male

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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.

• Bramley Birrer DDS PLLC

  • General Practice Dentistry
  • Seattle, WA
  • NPI 1306346028
  NPD (past)
• Nurani, Mitchell, Kim, PC

  • Dentist
  • Kent, WA
  • NPI 1053756049
  NPD (past)

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

{
    "created_epoch": "1485734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1523664000000",
    "number": "1104363019",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2144 9TH AVE W",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981192843",
            "telephone_number": "917-226-7669"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25610 104TH AVE SE",
            "city": "KENT",
            "state": "WA",
            "postal_code": "980307610",
            "telephone_number": "253-850-9777"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9730 3rd Ave NE Ste 205",
            "address_purpose": "LOCATION",
            "city": "Seattle",
            "state": "WA",
            "postal_code": "981152023",
            "country_code": "US",
            "telephone_number": "206-367-6453",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PARK",
        "first_name": "HOSAN",
        "name_prefix": "Dr.",
        "credential": "D.D.S",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-01-30",
        "last_updated": "2018-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "IL",
            "license": "019.031420",
            "primary": false
        },
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "WA",
            "license": "DE60722033",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Eve Paretsky, M.D.
• Divya Parihar, M.D
• Park Kent Dental and Denture LLP
• Jimin Park-Reeves, D.M.D.
• Alcina J Park, DOT
• Paul Park
• Arkar Parker, AAC
• C Bruce Parker
• Kate Marie Parker
• Tracee Lee Parker, M.S.

• Periodontics in Kent, WA
• Providers in Kent, WA by specialty
• Periodontics in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2018; 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.