Jin Hwi Park, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

051713-1 Issued in NY

Practice address

9295 Magnolia Ave
#103
Riverside, CA 92503-3800

Phone

(917) 533-2011

NPI assigned

Mar 6, 2007

Sex

Male

Sole proprietor

No

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: jpark1473085@oc.providencedirect.org

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.

• Jin H Park DDS Inc

  • Dental Clinic/Center
  • Riverside, CA
  • NPI 1265873749
  NPD (past) Authorized official

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

{
    "created_epoch": "1173139200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1363219200000",
    "number": "1164552246",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9295 MAGNOLIA AVE",
            "address_2": "#103",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925033800",
            "telephone_number": "917-533-2011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9295 MAGNOLIA AVE",
            "address_2": "#103",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925033800",
            "telephone_number": "917-533-2011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "JIN",
        "middle_name": "HWI",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-06",
        "last_updated": "2013-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "051713-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hanseul Park, DDS
• Ho Eun Park
• Jaein Park
• James Jinho Park, MD
• Jim Sang Park, D.D.S
• Jong Min Park, PHARMD.
• Julie Son Park
• Kyungsin Park, DDS
• Melissa Park, RN
• Myung Kee Park, DDS

• Dentist in Riverside, CA
• Providers in Riverside, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2013; 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.