Jin S Park

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

37476 Issued in CA

Practice address

8428 Alondra Blvd
Paramount, CA 90723-4406

Phone

(562) 633-6566

Fax

(562) 633-3308

NPI assigned

Mar 5, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Dr. James Park Professional name

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: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Jin S Park DDS PC

  dba Paramount Dental Center

  • General Practice Dentistry
  • Paramount, CA
  • NPI 1982733770
  NPD (past) Authorized official

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

{
    "created_epoch": "1173052800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1710016514",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8428 ALONDRA BLVD",
            "city": "PARAMOUNT",
            "state": "CA",
            "postal_code": "907234406",
            "telephone_number": "562-633-6566",
            "fax_number": "562-633-3308"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8428 ALONDRA BLVD",
            "city": "PARAMOUNT",
            "state": "CA",
            "postal_code": "907234406",
            "telephone_number": "562-633-6566",
            "fax_number": "562-633-3308"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "JIN",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "37476",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "B 37476",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JAMES",
            "last_name": "PARK",
            "prefix": "DR.",
            "credential": "DDS",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Paramount Meadows Nursing Center LP
• Paramount Physicians Health Center
• Paramount Physicians Medical Center
• Paramount Surgery Center, Inc
• Paramount Usd
• Aishani Patel
• Jagruti R. Patel, PHARMACIST
• Jayantilal G Patel, D.D.S
• Shailesh Patel
• Ronan Basillote Patonona, NP-C

• General Practice Dentistry in Paramount, CA
• Providers in Paramount, 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 Jul 8, 2007; 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.