NPIMap

Organization Active NPI

Jun Gyu Park, D.D.S., Inc.

  • Dental Clinic/Center
  • Garden Grove, CA
National Provider Identifier
1245742956
Registry record updated Dec 17, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
License
101441 Issued in CA
Legal business name
JUN GYU PARK, D.D.S., INC.
Practice address
12372 Euclid St
Garden Grove, CA 92840-3308
Phone
(714) 539-1004
NPI assigned
Nov 3, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 17, 2017

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

Authorized official

Name
Dr. Jun Gyu Park, DDSNPI 1851800072
Title
Ceo
Phone
(714) 539-1004

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X 101441 CA Primary

Addresses

Primary practice location

12372 Euclid St
Garden Grove, CA 92840-3308

Mailing address

12372 Euclid St
Garden Grove, CA 92840-3308
Phone (714) 539-1004

National Provider Directory

National Provider Directory

Locations

12372 Euclid St
Garden Grove, CA 92840
Phone (714) 539-1004

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1509667200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1513468800000",
    "number": "1245742956",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12372 EUCLID ST",
            "city": "GARDEN GROVE",
            "state": "CA",
            "postal_code": "928403308",
            "telephone_number": "714-539-1004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12372 EUCLID ST",
            "city": "GARDEN GROVE",
            "state": "CA",
            "postal_code": "928403308",
            "telephone_number": "714-539-1004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JUN GYU PARK, D.D.S., INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-11-03",
        "last_updated": "2017-12-17",
        "status": "A",
        "authorized_official_last_name": "PARK",
        "authorized_official_first_name": "JUN GYU",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "714-539-1004",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "CA",
            "license": "101441",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Garden Grove, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2017; 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.