Yong Jun David Park, DDS MD

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

52768 Issued in CA

Practice address

12777 Valley View St Ste 121
Garden Grove, CA 92845-2521

Phone

(714) 897-3543

Fax

(714) 897-0505

NPI assigned

Jan 30, 2008

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Dr. David Yong Park Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Jan 26, 2023 through Jan 26, 2027

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

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.

• Curtis B. Chu, D.D.S., Inc.

  dba Victorville Oral and Maxillofacial Surgery

  • Oral and Maxillofacial Surgery (Dentist)
  • Victorville, CA
  • NPI 1568318681
  NPD (past)

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

{
    "created_epoch": "1201651200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1569369600000",
    "number": "1215114301",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12777 VALLEYVIEW ST. #121",
            "city": "GARDEN GROVE",
            "state": "CA",
            "postal_code": "928458318",
            "telephone_number": "714-897-3543",
            "fax_number": "714-897-0505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12777 VALLEY VIEW ST STE 121",
            "city": "GARDEN GROVE",
            "state": "CA",
            "postal_code": "928452521",
            "telephone_number": "714-897-3543",
            "fax_number": "714-897-0505"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7677 Center Ave Ste 409",
            "address_purpose": "LOCATION",
            "city": "Huntington Beach",
            "state": "CA",
            "postal_code": "926473098",
            "country_code": "US",
            "telephone_number": "714-897-3543",
            "fax_number": "714-897-0505",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PARK",
        "first_name": "YONG JUN",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "DDS MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-01-30",
        "last_updated": "2019-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "CA",
            "license": "52768",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DAVID",
            "last_name": "PARK",
            "middle_name": "YONG",
            "prefix": "DR.",
            "credential": "DDS MD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Steven Park
• Sue Park, LAC
• Tracy Tom Park, O.D.
• We Sun Park
• William Byung Ho Park, M.D.
• Yujin Park
• Brooke Parker
• Sunshine Parker, M.A., SLP
• Catherine Parkins
• Cassandra Marie Parkman

• Oral and Maxillofacial Surgery (Dentist) in Garden Grove, CA
• Providers in Garden Grove, CA by specialty
• Oral and Maxillofacial Surgery (Dentist) in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.