Jonah Park

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

61260 Issued in CA

Practice address

7840 Firestone Blvd Ste 106
Downey, CA 90241-4257

Phone

(562) 923-0997

Fax

(562) 923-0683

NPI assigned

Jun 13, 2012

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Dental Practice of Jonah J Park DDS Inc

  • Dental Clinic/Center
  • Downey, CA
  • NPI 1629546304
  NPD Authorized official

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

{
    "created_epoch": "1339545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667001600000",
    "number": "1306108410",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7840 FIRESTONE BLVD STE 106",
            "city": "DOWNEY",
            "state": "CA",
            "postal_code": "902414257",
            "telephone_number": "562-923-0997"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7840 FIRESTONE BLVD STE 106",
            "city": "DOWNEY",
            "state": "CA",
            "postal_code": "902414257",
            "telephone_number": "562-923-0997",
            "fax_number": "562-923-0683"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "JONAH",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-06-13",
        "last_updated": "2022-10-29",
        "certification_date": "2022-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "61260",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jeremiah Paul Paredes, COTA/L
• Park Anesthesia a Nursing Corporation (Park Anesthesia)
• Janice Park-Kim, DDS
• Anna Nayoung Park
• Esther Park
• Jun Sup Park, DDS
• Jung Mok Park, M.D.
• Kevin S. Park, M.D.
• Michelle Ahleum Park
• Michelle Anna Park, PHARM.D.

• General Practice Dentistry in Downey, CA
• Providers in Downey, 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 Oct 29, 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.