Byungjun Park, DDS, PLLC

Primary specialty

DentistTaxonomy code 122300000X

License

60048922 Issued in WA

Legal business name

BYUNGJUN PARK, DDS, PLLC

Practice address

1551 116TH Ave NE
Suite B-1
Bellevue, WA 98004-3814

Phone

(425) 373-1605

NPI assigned

Dec 20, 2012

Organization subpart

No

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

Authorized official

Name

Byungjun Park, DDS

Title

Member

Phone

(425) 373-1605

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1355961600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1355961600000",
    "number": "1588900419",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1551 116TH AVE NE",
            "address_2": "SUITE B-1",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980043814",
            "telephone_number": "425-373-1605"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1551 116TH AVE NE",
            "address_2": "SUITE B-1",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980043814",
            "telephone_number": "425-373-1605"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BYUNGJUN PARK, DDS, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-12-20",
        "last_updated": "2012-12-20",
        "status": "A",
        "authorized_official_last_name": "PARK",
        "authorized_official_first_name": "BYUNGJUN",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "425-373-1605",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "WA",
            "license": "60048922",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• 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 Dec 20, 2012; 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.