Jaein Park DDS Inc

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

JAEIN PARK DDS INC

Practice address

2048 Orange Tree LN Ste 100
Redlands, CA 92374-4566

Phone

(909) 953-5140

NPI assigned

Aug 5, 2021

Organization subpart

No

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

Authorized official

Name

Jaein Park, DDSNPI 1265627913

Title

C.E.O.

Phone

(909) 593-5140

Specialties & licenses 1

Addresses

Locations

Practitioners 2

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

• Jaein Park

  • Dentist
  • Riverside, CA
  • NPI 1265627913
  NPD (past) Authorized official
• Sae Hwan Chung, DDS

  • Dentist
  • Redlands, CA
  • NPI 1972759983
  NPD

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

{
    "created_epoch": "1628121600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1628121600000",
    "number": "1285308841",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25519 CARROL CT",
            "city": "LOMA LINDA",
            "state": "CA",
            "postal_code": "923543700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2048 ORANGE TREE LN STE 100",
            "city": "REDLANDS",
            "state": "CA",
            "postal_code": "923744566",
            "telephone_number": "909-953-5140"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JAEIN PARK DDS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-08-05",
        "last_updated": "2021-08-05",
        "certification_date": "2021-08-05",
        "status": "A",
        "authorized_official_last_name": "PARK",
        "authorized_official_first_name": "JAEIN",
        "authorized_official_title_or_position": "C.E.O.",
        "authorized_official_telephone_number": "909-593-5140",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shiny Jacob
• Angelica Jacques, CCC-SLP
• Elaine Marie Jacques, M.S., CCC-SLP
• Jaehoon Lee Optometry Corp
• Jaehoon Lee Redlands Optometry
• Akshat Jain, MD
• Ginee Jain, D.M.D., M.P.H.
• Jagan Mohanrao Jakkula
• Jalpan Shah DDS MDS Inc.
• James L Munson MD Inc

• General Practice Dentistry in Redlands, CA
• Providers in Redlands, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2021; 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.