Dohee Park I, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

22DI02176400 Issued in NJ

Practice address

47 Kearny Ave
Kearny, NJ 07032-2332

Phone

(201) 998-1400

Fax

(201) 998-1425

NPI assigned

Dec 27, 2006

Sex

Male

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

Enrolled in NJ

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1167177600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724371200000",
    "number": "1295890374",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "47 KEARNY AVE",
            "city": "KEARNY",
            "state": "NJ",
            "postal_code": "070322332",
            "telephone_number": "201-998-1400",
            "fax_number": "201-998-1425"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "47 KEARNY AVE",
            "city": "KEARNY",
            "state": "NJ",
            "postal_code": "070322332",
            "telephone_number": "201-998-1400",
            "fax_number": "201-998-1425"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "DOHEE",
        "name_prefix": "Dr.",
        "name_suffix": "I",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-27",
        "last_updated": "2024-08-23",
        "certification_date": "2024-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NJ",
            "license": "22DI02176400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anton Orlov, PHARMD
• Ariel O Otero-Rodriguez, DMD
• Anna Padykula, M.D.
• Joshua Emmanuel Pagan Busigo
• Kiriakos Panterlis, DC
• Ankita B Patel
• Kunjesh A Patel, PHARMD
• Manilal A Patel, RPH
• Pathways to Independence, Inc.
• Xiomara D Paz

• General Practice Dentistry in Kearny, NJ
• Providers in Kearny, NJ by specialty
• General Practice Dentistry in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.