Sung Wook Park, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

101539 Issued in CA

Practice address

14930 Imperial Hwy Ste D
La Mirada, CA 90638-2100

Phone

(562) 777-1234

Fax

(562) 777-2345

NPI assigned

Aug 8, 2017

Sex

Male

Sole proprietor

Yes

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

Practice roles

Locations

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.

• Koh and Park DDS Inc

  • Dental Clinic/Center
  • Laguna Hills, CA
  • NPI 1558182998
  NPD Authorized official
• Park Cho Dental Partnership

  • Dental Clinic/Center
  • La Mirada, CA
  • NPI 1992424402
  NPD Authorized official

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

{
    "created_epoch": "1502150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597536000000",
    "number": "1578088779",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "80 MEANDER",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926207362",
            "telephone_number": "909-553-3786"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14930 IMPERIAL HWY STE D",
            "city": "LA MIRADA",
            "state": "CA",
            "postal_code": "906382100",
            "telephone_number": "562-777-1234",
            "fax_number": "562-777-2345"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1579 N D St",
            "address_purpose": "LOCATION",
            "city": "San Bernardino",
            "state": "CA",
            "postal_code": "924054742",
            "country_code": "US",
            "telephone_number": "909-889-1977",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PARK",
        "first_name": "SUNG WOOK",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-08-08",
        "last_updated": "2020-08-16",
        "certification_date": "2020-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "101539",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kathleen Segura Pangilinan, RDH ; RDHAP
• Park Cho Dental Partnership
• Jeung Hyun Park, L.AC
• Marisa Park
• Sehjin Park
• Khulwinder Singh Parmar, D.C.
• Torrey Parry, M.D.
• Neelam Patel
• Mary H. Patuwo, D.D.S.
• Carla M Payton-Shelton

• Dentist in La Mirada, CA
• Providers in La Mirada, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2020; 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.