Individual provider Active NPI

Yun Kyoung Park, D.D.S

  • Dentist
  • Palatine, IL
National Provider Identifier
1619424967
Registry record updated May 3, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
019.030894 Issued in IL
Practice address
249 W Dundee Rd
Palatine, IL 60074-2699
Phone
(847) 358-9700
NPI assigned
Sep 3, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 3, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 019.030894 IL Primary

Addresses

Primary practice location

249 W Dundee Rd
Palatine, IL 60074-2699

Mailing address

2700 Martin Luther King Jr Blvd
Detroit, MI 48208-2576

Other practice location 1

247 Dundee Ave
Elgin, IL 60120-4235
Phone (917) 365-8092

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
019.030894ILMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Sean a. Marfia D.M.D., P.C. Past Accepting new patients
VL Dental Care Dentist Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1472860800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1556841600000",
    "number": "1619424967",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2700 MARTIN LUTHER KING JR BLVD",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482082576"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "249 W DUNDEE RD",
            "city": "PALATINE",
            "state": "IL",
            "postal_code": "600742699",
            "telephone_number": "847-358-9700"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "247 Dundee Ave",
            "address_purpose": "LOCATION",
            "city": "Elgin",
            "state": "IL",
            "postal_code": "601204235",
            "country_code": "US",
            "telephone_number": "917-365-8092",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PARK",
        "first_name": "YUN KYOUNG",
        "name_prefix": "Dr.",
        "credential": "D.D.S",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-09-03",
        "last_updated": "2019-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": "019.030894",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palatine, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2019; 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.