Individual provider Active NPI

Yunah Park, DDS

  • General Practice Dentistry
  • Honolulu, HI
National Provider Identifier
1114442217
Registry record updated Aug 9, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DT-2711 Issued in HI
Practice address
500 Ala Moana Boulevard
Seven Waterfront Plaza, #220
Honolulu, HI 96813
Phone
(808) 523-3104
Fax
(808) 523-3121
NPI assigned
Aug 9, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 9, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DT-2711 HI Primary

Addresses

Primary practice location

500 Ala Moana Boulevard
Seven Waterfront Plaza, #220
Honolulu, HI 96813

Mailing address

328 Irving Ave Apt 1a
Brooklyn, NY 11237-5705

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
DT-2711HIMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1502236800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1502236800000",
    "number": "1114442217",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "328 IRVING AVE APT 1A",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112375705"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 ALA MOANA BOULEVARD",
            "address_2": "SEVEN WATERFRONT PLAZA, #220",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "96813",
            "telephone_number": "808-523-3104",
            "fax_number": "808-523-3121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "YUNAH",
        "name_prefix": "Miss",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-08-09",
        "last_updated": "2017-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "HI",
            "license": "DT-2711",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Honolulu, HI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2017; 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.