Gene Hyounglin Park, D.D.S., M.S.

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

49631 Issued in CA

Practice address

1031 Rosecrans Ave Ste 104
Fullerton, CA 92833-1946

Phone

(714) 519-3932

Fax

(714) 519-3935

NPI assigned

Apr 25, 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

• Hyoung Jin Park Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

State licenses

Practice roles

Locations

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.

• GH Park DDS a Dental Corporation

  • Dental Clinic/Center
  • Fullerton, CA
  • NPI 1780192005
  NPD Authorized official

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

{
    "created_epoch": "1209081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762387200000",
    "number": "1235304791",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1031 ROSECRANS AVE STE 104",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928331946",
            "telephone_number": "714-519-3932",
            "fax_number": "714-519-3935"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1031 ROSECRANS AVE STE 104",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928331946",
            "telephone_number": "714-519-3932",
            "fax_number": "714-519-3935"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "GENE",
        "middle_name": "HYOUNGLIN",
        "credential": "D.D.S., M.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-04-25",
        "last_updated": "2025-11-06",
        "certification_date": "2025-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "CA",
            "license": "49631",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "HYOUNG JIN",
            "last_name": "PARK",
            "credential": "DDS, MS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Chanjoon Park, LAC
• Cliff Jaebum Park
• Connie M. Park, O.D.
• David J Park, M.D.
• Eugene Park, L.AC.
• Heejin Park
• Jaeyong Park, LAC
• James Keonuk Park, D.D.S.
• Janice Hyejin Park, PHARMD
• Jennifer Park

• Periodontics in Fullerton, CA
• Providers in Fullerton, CA by specialty
• Periodontics in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2025; 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.