Bellevue Park Dental

Primary specialty

DentistTaxonomy code 122300000X

License

DE60554985 Issued in WA

Legal business name

BELLEVUE PARK DENTAL

Practice address

1551 116TH Ave NE
Suite #B1
Bellevue, WA 98004-3814

Phone

(425) 373-1605

Fax

(425) 373-1475

NPI assigned

May 12, 2015

Last updated

Sep 18, 2015By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Byungjun Park, D.D.SNPI 1306091418

Title

Owner

Phone

(425) 373-1605

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Byungjun Park, D.D.S.

  • General Practice Dentistry
  • Bellevue, WA
  • NPI 1306091418
  NPD (past) Authorized official

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

{
    "created_epoch": "1431388800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1442534400000",
    "number": "1568840429",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1551 116TH AVE NE",
            "address_2": "SUITE #B1",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980043814",
            "telephone_number": "425-373-1605",
            "fax_number": "425-373-1475"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1551 116TH AVE NE",
            "address_2": "SUITE #B1",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980043814",
            "telephone_number": "425-373-1605",
            "fax_number": "425-373-1475"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BELLEVUE PARK DENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-05-12",
        "last_updated": "2015-09-18",
        "status": "A",
        "authorized_official_last_name": "PARK",
        "authorized_official_first_name": "BYUNGJUN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "425-373-1605",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "WA",
            "license": "DE60554985",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bellevue Neuromuscular Dentistry LLC
• Bellevue OBGYN LLC
• Bellevue Optometry Clinic PS (Bellevue Optometry Clinic)
• Bellevue Orthopedic Physicians PLLC (Bellevue Hand Surgery)
• Bellevue Pain and Wellness PLLC
• Bellevue Physiatry and Electrodiagnosis LLC
• Bellevue Plastic Surgery Center (Newvue Plastic Surgery PC)
• Bellevue Podiatric Physicians PLLC
• Bellevue Podiatry Inc.
• Bellevue Psychotherapy, PS LTD

• Dentist in Bellevue, WA
• Providers in Bellevue, WA by specialty
• Dentist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2015; 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.