Young C. Park, DDS., PC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

License

0401412589 Issued in VA

Legal business name

YOUNG C. PARK, DDS., PC

Practice address

6625 Williamson Rd
Roanoke, VA 24019-4631

Phone

(540) 563-9398

NPI assigned

Jul 19, 2011

Organization subpart

No

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

Authorized official

Name

Young Chul Park, DDSNPI 1538396189

Title

President

Phone

(540) 563-9398

Specialties & licenses 1

Addresses

Other names 1

• Park Dental Doing business as

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Young Chul Park, DDS

  • Dentist
  • Roanoke, VA
  • NPI 1538396189
  NPD Authorized official
• Mariam Saadah

  • Dentist
  • Orland Park, IL
  • NPI 1477231363
  NPD (past)

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

{
    "created_epoch": "1311033600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1655596800000",
    "number": "1578851002",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6625 WILLIAMSON RD",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240194631",
            "telephone_number": "540-563-9398"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6625 WILLIAMSON RD",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240194631",
            "telephone_number": "540-563-9398"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "YOUNG C. PARK, DDS., PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-07-19",
        "last_updated": "2022-06-19",
        "certification_date": "2022-06-19",
        "status": "A",
        "authorized_official_last_name": "PARK",
        "authorized_official_first_name": "YOUNG",
        "authorized_official_middle_name": "CHUL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "540-563-9398",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "VA",
            "license": "0401412589",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Park Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Tiffany Yoon
• Denise T Yopp, LPC
• Ian Robert Yorston
• You Matter Counseling & Care, LLC
• You Show US, LLC
• Amanda Michelle Young
• Annie Grace Young
• Bryanna Young
• Christine Leeanne Young, M.D.
• Janet Young, MD

• Dental Clinic/Center in Roanoke, VA
• Providers in Roanoke, VA by specialty
• Dental Clinic/Center in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2022; 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.