Brandon Joon Park

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

113482 Issued in CA

Practice address

1591 Griffin Road
Twentynine Palms, CA 92278

Phone

(760) 830-7052

NPI assigned

Jul 31, 2026

Sex

Male

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1785456000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785456000000",
    "number": "1407779168",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1591 GRIFFIN ROAD,",
            "city": "TWENTYNINE PALMS",
            "state": "CA",
            "postal_code": "92278"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1591 GRIFFIN ROAD",
            "city": "TWENTYNINE PALMS",
            "state": "CA",
            "postal_code": "92278",
            "telephone_number": "760-830-7052"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "BRANDON",
        "middle_name": "JOON",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2026-07-31",
        "last_updated": "2026-07-31",
        "certification_date": "2026-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "113482",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Denice Ornelaz-Perez
• Matthew Osmak, DDS
• Prince Mensah Owusu, DNP-PMHNP
• Llana Paco
• Sarah Camille Paje, D.M.D
• Paul Park
• Brandi Parks
• Kaila D Peterson
• Kimberly Pistell, DO
• Paul Portis, RBT

• General Practice Dentistry in Twentynine Palms, CA
• Providers in Twentynine Palms, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2026; 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.