Chloe Mihyeonhan Park, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

64557 Issued in CA

Practice address

1687 Hyacinth Ave
Redlands, CA 92373-4217

Phone

(909) 645-1129

NPI assigned

Sep 17, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1442448000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663804800000",
    "number": "1295104453",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1687 HYACINTH AVE",
            "city": "REDLANDS",
            "state": "CA",
            "postal_code": "923734217"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1687 HYACINTH AVE",
            "city": "REDLANDS",
            "state": "CA",
            "postal_code": "923734217",
            "telephone_number": "909-645-1129"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "CHLOE",
        "middle_name": "MIHYEONHAN",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-09-17",
        "last_updated": "2022-09-22",
        "certification_date": "2022-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "DDS64557",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "64557",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Olivia M Papacostea, M.D.
• Paradigm Physical Therapy & Wellness PC
• Paresh Giri M.D. Inc.
• Reza Parhizkar
• Caitlyn Park
• Ellen Park, DDS
• Jonathan Park
• Kenneth J Park, DO
• Moses I Park, M.D.
• Shelley J Park, N.P.

• 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 Sep 22, 2022; 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.