Wookwon Park DDS PLLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

28444 Issued in TX

Legal business name

WOOKWON PARK DDS PLLC

Practice address

771 W Round Grove Rd
Ste W100
Lewisville, TX 75067

Phone

(469) 293-2530

NPI assigned

Oct 7, 2015

Organization subpart

No

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

Authorized official

Name

Dr. Wookwon Park, D.D.S

Title

Owner

Phone

(469) 293-2530

Specialties & licenses 1

Addresses

Other names 1

• Park Dental Clinic Doing business as

Locations

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

{
    "created_epoch": "1444176000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1444176000000",
    "number": "1326419052",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "771 W ROUND GROVE RD",
            "address_2": "STE W100",
            "city": "LEWISVILLE",
            "state": "TX",
            "postal_code": "75067",
            "telephone_number": "469-293-2530"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "771 W ROUND GROVE RD",
            "address_2": "STE W100",
            "city": "LEWISVILLE",
            "state": "TX",
            "postal_code": "75067",
            "telephone_number": "469-293-2530"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WOOKWON PARK DDS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-10-07",
        "last_updated": "2015-10-07",
        "status": "A",
        "authorized_official_last_name": "PARK",
        "authorized_official_first_name": "WOOKWON",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "469-293-2530",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "28444",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Park Dental Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Michael Wray, D.O.
• Dianna Wright, M.S., LPC

• General Practice Dentistry in Lewisville, TX
• Providers in Lewisville, TX by specialty
• General Practice Dentistry in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2015; 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.