Taehoon Park DDS Inc

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

56079 Issued in CA

Legal business name

TAEHOON PARK DDS INC

Practice address

20162 US Highway 18 Ste L
Apple Valley, CA 92307-2935

Phone

(760) 946-1466

Fax

(760) 946-1956

NPI assigned

Jun 15, 2015

Last updated

Jun 15, 2015By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Tae-Hoon Park, D.D.S.

Title

President

Phone

(760) 946-1466

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1434326400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1434326400000",
    "number": "1659752731",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20162 US HIGHWAY 18 STE L",
            "city": "APPLE VALLEY",
            "state": "CA",
            "postal_code": "923072935",
            "telephone_number": "760-946-1466",
            "fax_number": "760-946-1956"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20162 US HIGHWAY 18 STE L",
            "city": "APPLE VALLEY",
            "state": "CA",
            "postal_code": "923072935",
            "telephone_number": "760-946-1466",
            "fax_number": "760-946-1956"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TAEHOON PARK DDS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-06-15",
        "last_updated": "2015-06-15",
        "status": "A",
        "authorized_official_last_name": "PARK",
        "authorized_official_first_name": "TAE-HOON",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "760-946-1466",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "56079",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shannon Sweda
• Stephanie Sweem
• Syed J Raza MD Inc
• Symmetry Physical Therapy Inc
• James Michael Syms, P.T.
• Tracy Anne Taggart, M.D.
• Omar Zahoor Tahir, MD
• Devin Tang, MD
• Eileen Tang
• Sontung Thao Tang, PHARMD.

• General Practice Dentistry in Apple Valley, CA
• Providers in Apple Valley, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2015; 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.