Active NPI
Jenny Park
- Dentist
- Lancaster, PA
National Provider Identifier
1407296965
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- DS039525
- Practice address
- 1685 Crown Ave
Lancaster, PA 17601-6322 - Phone
- (215) 983-2624
- NPI assigned
- Jun 28, 2013
- Sex
- Female
- Sole proprietor
- Yes
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 | DS039525 | PA | Primary |
Addresses
Primary practice location
1685 Crown Ave
Lancaster, PA 17601-6322
Mailing address
1685 Crown Ave
Lancaster, PA 17601-6322
Phone (215) 983-2624
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 |
|---|---|---|---|
| DS039525 | PA | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1372377600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1753920000000",
"number": "1407296965",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1685 CROWN AVE",
"city": "LANCASTER",
"state": "PA",
"postal_code": "176016322",
"telephone_number": "215-983-2624"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1685 CROWN AVE",
"city": "LANCASTER",
"state": "PA",
"postal_code": "176016322",
"telephone_number": "215-983-2624"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PARK",
"first_name": "JENNY",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2013-06-28",
"last_updated": "2025-07-31",
"certification_date": "2025-07-31",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "PA",
"license": "DS039525",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lancaster, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 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.