Woo Sung Park, D.D.S., M.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

54186 Issued in CA

Practice address

3130 W Olympic Blvd Ste 320
Los Angeles, CA 90006-2494

Phone

(323) 766-2888

Fax

(323) 766-2822

NPI assigned

May 8, 2009

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1241740800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1241740800000",
    "number": "1144454869",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3130 W OLYMPIC BLVD STE 320",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900062494",
            "telephone_number": "323-766-2888",
            "fax_number": "323-766-2822"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3130 W OLYMPIC BLVD STE 320",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900062494",
            "telephone_number": "323-766-2888",
            "fax_number": "323-766-2822"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "WOO SUNG",
        "credential": "D.D.S., M.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-05-08",
        "last_updated": "2009-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "54186",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Wendy Ann Park, LCSW. MBA
• Wilson C Park, D.C.
• Wilson Ho Park, MD
• Won Bo Park, DDS
• Wonju Park, NP
• Yeongju Park, L,AC
• Yeri Park, MD
• Yong Hwan Park, D.C
• Yong S. Park, MD
• Yong Sue Park, PHD

• General Practice Dentistry in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.