Active NPI
Yun Jun Park, DDS
- Dentist
- New Lenox, IL
National Provider Identifier
1346074002
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 019035483
- Practice address
- 561 E Lincoln Hwy
New Lenox, IL 60451-1909 - Phone
- (815) 242-0150
- NPI assigned
- Aug 27, 2024
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 019035483 | IL | Primary |
Addresses
Primary practice location
561 E Lincoln Hwy
New Lenox, IL 60451-1909
Mailing address
411 Janes Ave Unit 214
Bolingbrook, IL 60440-2744
Phone (630) 884-4317
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 019035483 | IL | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1724716800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1740614400000",
"number": "1346074002",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "411 JANES AVE UNIT 214",
"city": "BOLINGBROOK",
"state": "IL",
"postal_code": "604402744",
"telephone_number": "630-884-4317"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "561 E LINCOLN HWY",
"city": "NEW LENOX",
"state": "IL",
"postal_code": "604511909",
"telephone_number": "815-242-0150"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PARK",
"first_name": "YUN JUN",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-08-27",
"last_updated": "2025-02-27",
"certification_date": "2025-02-27",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "IL",
"license": "019035483",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in New Lenox, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.