NPIMap

Organization Active NPI

Robert Taehong Park DDS, Inc.

  • Dentist
  • Los Angeles, CA
National Provider Identifier
1164542635
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
33351 Issued in CA
Legal business name
ROBERT TAEHONG PARK DDS, INC.
Practice address
4220 W 3Rd St
Ste 202
Los Angeles, CA 90020-3450
Phone
(213) 382-3215
NPI assigned
Mar 30, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Robert ParkNPI 1578749610
Title
C.E.O.
Phone
(213) 382-3215

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X 33351 CA Primary

Addresses

Primary practice location

4220 W 3Rd St
Ste 202
Los Angeles, CA 90020-3450

Mailing address

4220 W 3Rd St
Ste 202
Los Angeles, CA 90020-3450

National Provider Directory

National Provider Directory

Locations

4220 W 3rd St
Ste 202
Los Angeles, CA 90020
Phone (213) 382-3215

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1175212800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1164542635",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4220 W 3RD ST",
            "address_2": "STE 202",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900203450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4220 W 3RD ST",
            "address_2": "STE 202",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900203450",
            "telephone_number": "213-382-3215"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROBERT TAEHONG PARK DDS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-30",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "PARK",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "C.E.O.",
        "authorized_official_telephone_number": "213-382-3215"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "CA",
            "license": "33351",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.