Julie Park, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

0401418010 Issued in VA

Practice address

100 Gallatin St NE
Washington, DC 20011-7533

Phone

(844) 796-2797

Fax

(202) 483-0302

NPI assigned

Apr 25, 2021

Sex

Female

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

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/15126/brand/1/csg/1/fhir/r4

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

{
    "created_epoch": "1619308800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784505600000",
    "number": "1104408517",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2333 ONTARIO RD NW",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200092627"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 GALLATIN ST NE",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200117533",
            "telephone_number": "844-796-2797",
            "fax_number": "202-483-0302"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "JULIE",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-04-25",
        "last_updated": "2026-07-20",
        "certification_date": "2026-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "VA",
            "license": "0401418010",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "DC",
            "license": "DEN2000277",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Catherine Park, M.D.
• James Obedience Park Jr.
• Jay Hong-Geun Park, MD
• Jeremy Park, MD
• Jongmi Park
• Katherine Park, CAA
• Kevin Woo Park, MD
• Kyu Ja Park
• Matthew Park, M.D.
• Susie Park

• General Practice Dentistry in Washington, DC
• Providers in Washington, DC by specialty
• General Practice Dentistry in District of Columbia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2026; 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.