Jae Hong Park Dental, P.C.

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

Legal business name

JAE HONG PARK DENTAL, P.C.

Practice address

71 School St # 1010
Glen Cove, NY 11542-2511

Phone

(347) 509-4084

NPI assigned

Aug 9, 2023

Organization subpart

No

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

Authorized official

Name

Jae Hong Park, DMD

Title

President

Phone

(929) 888-5010

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1691539200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1691539200000",
    "number": "1609559491",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "184 KENT AVE APT A304",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112493176",
            "telephone_number": "929-888-5010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "71 SCHOOL ST # 1010",
            "city": "GLEN COVE",
            "state": "NY",
            "postal_code": "115422511",
            "telephone_number": "347-509-4084"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JAE HONG PARK DENTAL, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-08-09",
        "last_updated": "2023-08-09",
        "certification_date": "2023-08-09",
        "status": "A",
        "authorized_official_last_name": "PARK",
        "authorized_official_first_name": "JAE",
        "authorized_official_middle_name": "HONG",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "929-888-5010",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Naomi Israel, LPN
• Susanna N Ivask
• Helen Jablonowski-Parada, M.D.
• Kim B Jackson
• Richard G Jacobson, PAC
• Jaetris Homecare Solutions, Inc.
• Chowdhury Shakhawat Jahan
• JCB of Glen Cove
• Sanjiv Jhaveri, MD
• Katherine Jimenez, REGISTERED NURSE

• Pediatric Dentistry in Glen Cove, NY
• Providers in Glen Cove, NY by specialty
• Pediatric Dentistry in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2023; 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.