Charles Hee Yong Park, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

0401411122 Issued in VA

Practice address

4290 Chain Bridge Rd Ste 202
Fairfax, VA 22030-8158

Phone

(703) 828-6630

Fax

(888) 636-8702

NPI assigned

Feb 1, 2006

Last updated

Apr 27, 2019By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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

• Karis Dental, PLLC

  dba Karis Dental

  • General Practice Dentistry
  • Fairfax, VA
  • NPI 1326595083
  NPD (past) Authorized official

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

{
    "created_epoch": "1138752000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1556323200000",
    "number": "1639140023",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4290 CHAIN BRIDGE RD STE 202",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220308158",
            "telephone_number": "703-828-6630",
            "fax_number": "888-636-8702"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4290 CHAIN BRIDGE RD STE 202",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220308158",
            "telephone_number": "703-828-6630",
            "fax_number": "888-636-8702"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10107 Baltimore Ave Apt 4307",
            "address_purpose": "LOCATION",
            "city": "College Park",
            "state": "MD",
            "postal_code": "207404233",
            "country_code": "US",
            "telephone_number": "443-235-6758",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PARK",
        "first_name": "CHARLES",
        "middle_name": "HEE YONG",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-02-01",
        "last_updated": "2019-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "VA",
            "license": "0401411122",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Maria Fe P Paraguya, M.D.
• Paramount Care Physicians LLP
• Jasleen Parihar, PSYD
• Kinjal Parikh, MD
• Chan Young Park
• Cheon Gyu Park, D.C.
• Da Yon Park, PA-C
• Daniel Y Park, DPT
• Gina Park
• Heesun Park

• Dentist in Fairfax, VA
• Providers in Fairfax, VA by specialty
• Dentist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 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.