Janice Park-Kim, DDS

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

48658 Issued in CA

Practice address

7601 Imperial Hwy
Downey, CA 90242-3456

Phone

(562) 803-0124

Fax

(562) 803-5569

NPI assigned

Feb 19, 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

Enrolled in CA

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

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.

• Rancho Faculty Medical Associates, Inc.

  • General Acute Care Hospital
  • Downey, CA
  • NPI 1750317970
  NPD (past)

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

{
    "created_epoch": "1171843200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1306980511",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 30220",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900300220",
            "telephone_number": "562-803-0124",
            "fax_number": "562-803-5569"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7601 IMPERIAL HWY",
            "city": "DOWNEY",
            "state": "CA",
            "postal_code": "902423456",
            "telephone_number": "562-803-0124",
            "fax_number": "562-803-5569"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK-KIM",
        "first_name": "JANICE",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "CA",
            "license": "48658",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Panna a Khan
• Elizabeth Juppey Parackal, NP-C
• Amy Julissa Paredes
• Jeremiah Paul Paredes, COTA/L
• Park Anesthesia a Nursing Corporation
• Anna Nayoung Park
• Esther Park
• Jonah Park
• Jun Sup Park, DDS
• Jung Mok Park, M.D.

• Oral and Maxillofacial Surgery (Dentist) in Downey, CA
• Providers in Downey, CA by specialty
• Oral and Maxillofacial Surgery (Dentist) in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.