Ju Yeon Park, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

113343 Issued in CA

Practice address

775 Ikea CT Ste 130
West Sacramento, CA 95605-1663

Phone

(916) 839-4983

NPI assigned

Aug 3, 2026

Sex

Female

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

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.

• Dentists of West Sacramento, Inc

  • General Practice Dentistry
  • West Sacramento, CA
  • NPI 1508754144
  NPD (past)

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

{
    "created_epoch": "1785715200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785715200000",
    "number": "1417870809",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "775 IKEA CT STE 130",
            "city": "WEST SACRAMENTO",
            "state": "CA",
            "postal_code": "956051663",
            "telephone_number": "916-839-4983"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "775 IKEA CT STE 130",
            "city": "WEST SACRAMENTO",
            "state": "CA",
            "postal_code": "956051663",
            "telephone_number": "916-839-4983"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "JU YEON",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-08-03",
        "last_updated": "2026-08-03",
        "certification_date": "2026-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "113343",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Andrea Packheiser
• Ruth Pagano-TRN
• Aida Abobon Palma
• Ranier Paredes
• Julia Parella
• Lisa C Parker
• Rosemary Eileen Parker, ACSW
• Tracy Kristin Parsons, MS PT
• Selena Tina Patolo
• Patricia Temple

• General Practice Dentistry in West Sacramento, CA
• Providers in West Sacramento, 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 Aug 3, 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.