Victoria Jeong Park, DDS

Primary specialty

ProsthodonticsTaxonomy code 1223P0700X

License

057864 Issued in NY

Practice address

47 E 77TH St Ste 207
New York, NY 10075-1730

Phone

(646) 707-3456

NPI assigned

May 30, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Victoria Jeong Park DDS PC

  • Prosthodontics
  • New York, NY
  • NPI 1811600091
  NPD Authorized official

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

{
    "created_epoch": "1338336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672704000000",
    "number": "1689935389",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "47 E 77TH ST STE 207",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100751730",
            "telephone_number": "646-707-3456"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "47 E 77TH ST STE 207",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100751730",
            "telephone_number": "646-707-3456"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "VICTORIA",
        "middle_name": "JEONG",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-05-30",
        "last_updated": "2023-01-03",
        "certification_date": "2023-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "057864",
            "primary": false
        },
        {
            "code": "1223P0700X",
            "taxonomy_group": "",
            "desc": "Dentist, Prosthodontics",
            "state": "NY",
            "license": "057864",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Susie Park
• Thomas Park
• Tina Park, M.D.
• Tyler David Park, MD
• V Park, PHARM.D.
• Wungki Park, M.D.
• Yeon Su Park
• Yoo Jin Park
• Yookyung Andrea Park, O.D.
• You Jin Park

• Prosthodontics in New York, NY
• Providers in New York, NY by specialty
• Prosthodontics in New York

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