Woo Kwon Park, D.D.S

Primary specialty

DentistTaxonomy code 122300000X

License

28444 Issued in TX

Practice address

5701 Liberty Grove Rd
Suite 140
Rowlett, TX 75089-3623

Phone

(214) 703-0703

NPI assigned

Jul 25, 2012

Last updated

Sep 11, 2014By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Peppermint Dental

  dba Peppermint Dental & Orthodontics

  • Dentist
  • Rowlett, TX
  • NPI 1861641995
  NPD (past)

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

{
    "created_epoch": "1343174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1410393600000",
    "number": "1215283403",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "701 E BLUFF ST",
            "address_2": "APT 7207",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761022300",
            "telephone_number": "213-448-1888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5701 LIBERTY GROVE RD",
            "address_2": "SUITE 140",
            "city": "ROWLETT",
            "state": "TX",
            "postal_code": "750893623",
            "telephone_number": "214-703-0703"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "WOO KWON",
        "credential": "D.D.S",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-07-25",
        "last_updated": "2014-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "61550",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TX",
            "license": "28444",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Padmaja Doniparthi, MD, SC
• Pain Management Physicians of Dallas PLLC (Dallas Pain Consultants)
• Pain Technology Solutions
• Adriel Palma, CRNFA
• Joonyong Park
• Parker Family Chiropractic, P.a.
• Kevin Todd Parker, D.C.
• Sean G Parker, MD
• Bailey Anne Parsons, PA-C
• Patbar LLC (Clear Choice Senior Care)

• Dentist in Rowlett, TX
• Providers in Rowlett, TX by specialty
• Dentist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 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.