Jooyoelpark DDS Inc

Primary specialty

DentistTaxonomy code 122300000X

License

55530 Issued in CA

Legal business name

JOOYOELPARK DDS INC

Practice address

204 N Pacific Ave
San Pedro, CA 90731-2016

Phone

(310) 832-8800

Fax

(310) 832-8801

NPI assigned

Jun 18, 2013

Organization subpart

No

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

Authorized official

Name

Jooyoel Park, DDSNPI 1306979638

Title

Ceo

Phone

(310) 832-8800

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 1

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

• Jooyoel Park

  • Dentist
  • Cathedral City, CA
  • NPI 1306979638
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1371513600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1371513600000",
    "number": "1609215284",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "204 N PACIFIC AVE",
            "city": "SAN PEDRO",
            "state": "CA",
            "postal_code": "907312016",
            "telephone_number": "310-832-8800",
            "fax_number": "310-832-8801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "204 N PACIFIC AVE",
            "city": "SAN PEDRO",
            "state": "CA",
            "postal_code": "907312016",
            "telephone_number": "310-832-8800",
            "fax_number": "310-832-8801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOOYOELPARK DDS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-06-18",
        "last_updated": "2013-06-18",
        "status": "A",
        "authorized_official_last_name": "PARK",
        "authorized_official_first_name": "JOOYOEL",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "310-832-8800",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "CA",
            "license": "55530",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Candee Jones
• Carrissa Michelle Daino Jones
• Dandre Jones
• Gena Jones
• Johnny Jones
• Elia1 Jordan
• Joseph Bahan
• Esther Jou, LMFT
• Arantxa Jovellanos, PT, DPT
• Bojan Jovic, RPH

• Dentist in San Pedro, CA
• Providers in San Pedro, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.