Yong Eon Park, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

50806 Issued in CA

Practice address

1120 Calloway Drive
Suite 400
Bakersfield, CA 93312-6398

Phone

(661) 588-2772

Fax

(661) 588-3773

NPI assigned

Mar 20, 2007

Last updated

Jun 17, 2011By the provider in NPPES

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

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1174348800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1308268800000",
    "number": "1578688495",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1120 CALLOWAY DRIVE",
            "address_2": "SUITE 400",
            "city": "BAKERSFIELD",
            "state": "CA",
            "postal_code": "933126398",
            "telephone_number": "661-588-2772",
            "fax_number": "661-588-3773"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1120 CALLOWAY DRIVE",
            "address_2": "SUITE 400",
            "city": "BAKERSFIELD",
            "state": "CA",
            "postal_code": "933126398",
            "telephone_number": "661-588-2772",
            "fax_number": "661-588-3773"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "YONG EON",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-20",
        "last_updated": "2011-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "50806",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kiefer Sungwhan Park, DDS
• Kyoung Hee Park
• Kyung Choon Park, O.D.
• Nathaniel Jeong Su Park
• Woori Park
• Young Wu Park, MD
• Amanda Brooke Parker Trautmann, LCW
• Courtney Parker
• David Parker
• Jessie M Parker

• General Practice Dentistry in Bakersfield, CA
• Providers in Bakersfield, 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 Jun 17, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.