Sohee Kim Park, DMD, MHS

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

3592 Issued in SC

Practice address

456 Clemson Rd
Columbia, SC 29229-7925

Phone

(803) 788-9715

Fax

(803) 788-9705

NPI assigned

Jul 26, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Feb 23, 2014 through Feb 23, 2028

Medicare enrollment (NPD)

Enrolled

Practice roles

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.

• Sandhills Periodontics

  • Periodontics
  • Columbia, SC
  • NPI 1053800623
  NPD (past) Authorized official

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

{
    "created_epoch": "1153872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1553644800000",
    "number": "1700800497",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "456 CLEMSON RD",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292297925",
            "telephone_number": "803-788-9715",
            "fax_number": "803-788-9705"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "456 CLEMSON RD",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292297925",
            "telephone_number": "803-788-9715",
            "fax_number": "803-788-9705"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "SOHEE",
        "middle_name": "KIM",
        "name_prefix": "Dr.",
        "credential": "DMD, MHS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-26",
        "last_updated": "2019-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "SC",
            "license": "3592",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ZX3592",
            "state": "SC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "office@sandhillsperio.com",
            "affiliation": "N",
            "endpointDescription": "Email Address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "456 Clemson Rd",
            "city": "Columbia",
            "state": "SC",
            "country_code": "US",
            "postal_code": "292297925",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Pooja Parikh, DO
• Park & Phillips Eye Care PA (Dr Dorothy Park & Associates)
• Dorothy J Park, OD
• Hanjin Park Park
• Joseph Won-Joon Park, D.M.D
• Karen Carole Parker Williams, PT
• Anna Parker, RN
• Brandy Parker
• Debra A Parker
• Emily Cain Parker, PA-C

• Periodontics in Columbia, SC
• Providers in Columbia, SC by specialty
• Periodontics in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2019; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.