Soonjin Park, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

5588 Issued in NV

Practice address

10643 Professional Cir # 102
Reno, NV 89521-5851

Phone

(775) 737-4035

Fax

(775) 737-4036

NPI assigned

Jan 22, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

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": "1169424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1411430400000",
    "number": "1194879965",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10643 PROFESSIONAL CIR # 102",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895215851",
            "telephone_number": "775-737-4035",
            "fax_number": "775-737-4036"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10643 PROFESSIONAL CIR # 102",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895215851",
            "telephone_number": "775-737-4035",
            "fax_number": "775-737-4036"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "SOONJIN",
        "name_prefix": "Mrs.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-22",
        "last_updated": "2014-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "54772",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NV",
            "license": "5588",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ki Don Park, DDS
• Natasha Park, APRN
• Paul J Park, MD
• Seung Bai Park, O.M.D.
• Somakhanden Park, MI4032 AND CI5055
• Susan Jin-Sun Park, MD
• Alan Parker
• Bobbi-Jo C Parker
• Chauncey R. Parker IV, PH.D.
• Darryl Pernell Parker Jr., MASSAGE THERAPIST

• Dentist in Reno, NV
• Providers in Reno, NV by specialty
• Dentist in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2014; 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.