Jennifer Park, D.D.S

Primary specialty

DentistTaxonomy code 122300000X

License

DEN1001639 Issued in DC

Practice address

5750 Dow Ave Apt 241
Alexandria, VA 22304-4071

Phone

(443) 722-9856

NPI assigned

Jun 30, 2016

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)

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.

• Yk Dental Centreville PC

  • Dental Clinic/Center
  • Centreville, VA
  • NPI 1528558350
  NPD (past)

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

{
    "created_epoch": "1467244800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1467244800000",
    "number": "1538510599",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5750 DOW AVE APT 241",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "223044071",
            "telephone_number": "443-722-9856"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5750 DOW AVE APT 241",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "223044071",
            "telephone_number": "443-722-9856"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "JENNIFER",
        "name_prefix": "Dr.",
        "credential": "D.D.S",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-30",
        "last_updated": "2016-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "DC",
            "license": "DEN1001639",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anne Boston Parish, FNP-C
• David Park, MD
• Eun Hae Park, OTR/L
• Hae Jung Park
• Hye Young Park, D.M.D.
• Jessica Park
• Jung Hoon Park, D.D.S
• Rachel Hee Young Park, MD
• Rebecca Park
• Si-Eun Park, DMD

• Dentist in Alexandria, VA
• Providers in Alexandria, VA by specialty
• Dentist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2016; 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.