So Young Park, D.D.S.

Primary specialty

DentistTaxonomy code 122300000X

License

61708 Issued in CA

Practice address

1660 Westwood Dr Ste G
San Jose, CA 95125-5100

Phone

(408) 264-1917

NPI assigned

Oct 18, 2012

Sex

Female

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

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

{
    "created_epoch": "1350518400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1543881600000",
    "number": "1184977829",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1660 WESTWOOD DR STE G",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951255100",
            "telephone_number": "408-264-1917"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1660 WESTWOOD DR STE G",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951255100",
            "telephone_number": "408-264-1917"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "SO YOUNG",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-10-18",
        "last_updated": "2018-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "61708",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Misuk Park
• Nam Hee Ava Park, DDS
• Natalie Park, O.T.
• Olivia Park, PHARMACIST
• Rodney Kim Park, D.D.S.
• Sun Ja Park, D.C
• Tom S. Park, D.D.S.
• Uriel Park
• Yun Sang Park, O.D.
• Adam Carrier Parker, DPT

• Dentist in San Jose, CA
• Providers in San Jose, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2018; 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.