Dong Jun John Park, M.D.

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

A98835 Issued in CA

Practice address

180 Newport Center Dr Ste 170
Newport Beach, CA 92660-0937

Phone

(949) 777-6883

Fax

(949) 629-4011

NPI assigned

Jan 14, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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 and National Provider Directory roles.

• Ayala Arizmendi Dental Corporation

  • Dentist
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  • NPI 1568716603
  NPD (past)

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

{
    "created_epoch": "1137196800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641427200000",
    "number": "1700865052",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "180 NEWPORT CENTER DR STE 170",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926600937",
            "telephone_number": "949-777-6883",
            "fax_number": "949-629-4011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "180 NEWPORT CENTER DR STE 170",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926600937",
            "telephone_number": "949-777-6883",
            "fax_number": "949-629-4011"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1310 W Stewart Dr Ste 311",
            "address_purpose": "LOCATION",
            "city": "Orange",
            "state": "CA",
            "postal_code": "928683838",
            "country_code": "US",
            "telephone_number": "949-867-6458",
            "fax_number": "949-629-4011",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PARK",
        "first_name": "DONG JUN",
        "middle_name": "JOHN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-14",
        "last_updated": "2022-01-06",
        "certification_date": "2022-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "CA",
            "license": "A98835",
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "CA",
            "license": "A98835",
            "primary": true
        },
        {
            "code": "207WX0200X",
            "taxonomy_group": "",
            "desc": "Ophthalmology, Ophthalmic Plastic and Reconstructive Surgery",
            "state": "CA",
            "license": "A98835",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Abhay S Parikh, MD
• Lisa Anne Parissi, DC
• Zane Michael Parissi
• Park Superior Healthcare,LLC
• Christopher Park
• Hannah Park
• Hayley Sang Bee Park
• James Park, D.O.
• Norela Vanessa Park, PHARMD
• One I Park

• Ophthalmology Physician in Newport Beach, CA
• Providers in Newport Beach, CA by specialty
• Ophthalmology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2022; 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.

Verify at the official NPI Registry.