Active NPI
Hyang Min Park, D.M.D.
- General Practice Dentistry
- Harrisburg, PA
National Provider Identifier
1679929160
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- DS040844
- Practice address
- 3867 Union Deposit Rd
Harrisburg, PA 17109-5920 - Phone
- (717) 558-0042
- NPI assigned
- May 13, 2016
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | DS040844 | PA | Primary |
Addresses
Primary practice location
3867 Union Deposit Rd
Harrisburg, PA 17109-5920
Mailing address
350 N Clark St
Ste 600
Chicago, IL 60654-4712
Phone (312) 274-4526
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in PA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20231218003469 | PA | Order and Referring Only - Dentist | 6800174608 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DS040844 | PA | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1463097600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1464998400000",
"number": "1679929160",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "350 N CLARK ST",
"address_2": "STE 600",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606544712",
"telephone_number": "312-274-4526"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3867 UNION DEPOSIT RD",
"city": "HARRISBURG",
"state": "PA",
"postal_code": "171095920",
"telephone_number": "717-558-0042"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PARK",
"first_name": "HYANG MIN",
"credential": "D.M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-05-13",
"last_updated": "2016-06-04",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "PA",
"license": "DS040844",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Harrisburg, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.