Scott Juyoung Park, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DN122376 Issued in GA

Practice address

7155 Jonesboro Rd
Morrow, GA 30260-2908

Phone

(678) 904-5166

NPI assigned

Jul 1, 2021

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other names 1

• Ju Young Park Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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.

• Sunshine Smiles Dentistry

  • Dental Clinic/Center
  • Roswell, GA
  • NPI 1306373667
  NPD (past)
• Familia Dental Kenosha LLC

  • Dental Clinic/Center
  • Kenosha, WI
  • NPI 1154782209

  General Practice

  NPD (past)

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

{
    "created_epoch": "1625097600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747180800000",
    "number": "1376114207",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4632 DANDELION CIR NE",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300673660",
            "telephone_number": "404-313-6654"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7155 JONESBORO RD",
            "city": "MORROW",
            "state": "GA",
            "postal_code": "302602908",
            "telephone_number": "678-904-5166"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "SCOTT",
        "middle_name": "JUYOUNG",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-07-01",
        "last_updated": "2025-05-14",
        "certification_date": "2025-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "GA",
            "license": "DN122376",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WI",
            "license": "1002618-15",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019.033440",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JU",
            "last_name": "PARK",
            "middle_name": "YOUNG",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Caitlin Nicole Orr, M.A., CCC-SLP
• Ortho Sport & Spine Physicians Morrow
• Ossp Imaging of South Atlanta
• Our Parents Place
• Oyedoyin Oyelowo, MD
• Parsley Medical Group FL PA (Parsley Medical Group of GA)
• Jherricka Partido
• Peace It's Priceless (Peace)
• Peaceful Healthcare LLC
• Peach State Providers Group Inc

• General Practice Dentistry in Morrow, GA
• Providers in Morrow, GA by specialty
• General Practice Dentistry in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 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.

Verify at the official NPI Registry.