Hyun Jun Park

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

107086 Issued in CA

Practice address

27949 Greenspot Rd Ste H
Highland, CA 92346-4444

Phone

(909) 864-6010

NPI assigned

Oct 15, 2021

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

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.

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Hyun Jun Park DDS Inc

  • Dental Clinic/Center
  • Los Angeles, CA
  • NPI 1558184903
  NPD Authorized official
• Jefferson and Chokka Professional Dental Corporation

  • General Practice Dentistry
  • Highland, CA
  • NPI 1366688525
  NPD (past)

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

{
    "created_epoch": "1634256000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634256000000",
    "number": "1174286264",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2721 HOLLYVIEW CT",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900683089",
            "telephone_number": "213-503-9470"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27949 GREENSPOT RD STE H",
            "city": "HIGHLAND",
            "state": "CA",
            "postal_code": "923464444",
            "telephone_number": "909-864-6010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "HYUN JUN",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-10-15",
        "last_updated": "2021-10-15",
        "certification_date": "2021-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "107086",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Merijoy Padilla
• Melissa M Page, CCC-SLP
• Pan Am Medical, Inc.
• Elizabeth Park
• Eugene Hoon Park, PHARMD
• Larry A Park, M.D.
• Parker Family Counseling, Inc.
• Linda S Parker, MFT
• Luz Arely Parra
• Bhumika Patel

• General Practice Dentistry in Highland, CA
• Providers in Highland, 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 Oct 15, 2021; 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.