Jaein Park

Primary specialty

DentistTaxonomy code 122300000X

License

56255 Issued in CA

Practice address

16175 Blue Haven CT
Riverside, CA 92503-0524

Phone

(951) 343-7752

NPI assigned

Sep 6, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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.

• Jaein Park DDS Inc

  • General Practice Dentistry
  • Redlands, CA
  • NPI 1285308841
  NPD (past) Authorized official

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

{
    "created_epoch": "1189036800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1189036800000",
    "number": "1265627913",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16175 BLUE HAVEN CT",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925030524"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16175 BLUE HAVEN CT",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925030524",
            "telephone_number": "951-343-7752"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "JAEIN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-09-06",
        "last_updated": "2007-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "56255",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anthony J Park, MD
• Eunkyung Park, L.AC
• Hannah Park
• Hanseul Park, DDS
• Ho Eun Park
• James Jinho Park, MD
• Jim Sang Park, D.D.S
• Jin Hwi Park, DDS
• Jong Min Park, PHARMD.
• Julie Son Park

• Dentist in Riverside, CA
• Providers in Riverside, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2007; 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.