Active NPI
James Jaehyun Park, DDS
- General Practice Dentistry
- Mint Hill, NC
National Provider Identifier
1265554828
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 8329
- Practice address
- 4520 Mint Hill Village LN
Unit #107
Mint Hill, NC 28227 - Phone
- (704) 573-1198
- Fax
- (704) 573-6870
- NPI assigned
- Apr 4, 2007
- Last updated
- Aug 20, 2018
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 8329 | NC | Primary |
Addresses
Primary practice location
4520 Mint Hill Village LN
Unit #107
Mint Hill, NC 28227
Mailing address
4520 Mint Hill Village LN
Unit #107
Mint Hill, NC 28227-7796
Phone (704) 573-1198
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 8329 | NC | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ese Associates, Inc. | General Practice | Past | Accepting new patients |
| JP Associate, Inc. | General Practice | Past | Accepting new patients |
Organizations & group practices 2
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1175644800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1534723200000",
"number": "1265554828",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4520 MINT HILL VILLAGE LN",
"address_2": "UNIT #107",
"city": "MINT HILL",
"state": "NC",
"postal_code": "282277796",
"telephone_number": "704-573-1198",
"fax_number": "704-573-6870"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4520 MINT HILL VILLAGE LN",
"address_2": "UNIT #107",
"city": "MINT HILL",
"state": "NC",
"postal_code": "28227",
"telephone_number": "704-573-1198",
"fax_number": "704-573-6870"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PARK",
"first_name": "JAMES",
"middle_name": "JAEHYUN",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-04-04",
"last_updated": "2018-08-20",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "NC",
"license": "8329",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mint Hill, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.