Sunghae Park, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

57834 Issued in CA

Practice address

16709 Hawthorne Blvd
Lawndale, CA 90260-3244

Phone

(310) 542-5558

Fax

(310) 542-4309

NPI assigned

Oct 12, 2005

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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.

• Park, D.M.D., Corp.

  • General Practice Dentistry
  • Lawndale, CA
  • NPI 1457664070
  NPD (past) Authorized official
• Jason H. Ta, DMD, Inc.

  • Dentist
  • Lawndale, CA
  • NPI 1356810758
  NPD (past)

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

{
    "created_epoch": "1129075200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1477872000000",
    "number": "1760470769",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16709 HAWTHORNE BLVD",
            "city": "LAWNDALE",
            "state": "CA",
            "postal_code": "902603244",
            "telephone_number": "310-542-5558",
            "fax_number": "310-542-4309"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16709 HAWTHORNE BLVD",
            "city": "LAWNDALE",
            "state": "CA",
            "postal_code": "902603244",
            "telephone_number": "310-542-5558",
            "fax_number": "310-542-4309"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "SUNGHAE",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-10-12",
        "last_updated": "2016-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "57834",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8970106",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Santos Flavio Pacheco, M.D.
• Pandya Professional Dental Corporation
• Toral S Pandya, DDS
• Therese Jamie Parado, D.D.S.
• Park, D.M.D., Corp.
• Partnership Adult Home Care LLC
• Evelyn Yashnie Pasquel
• Nataly Perez
• Edmundo Perfecto
• Clara Pham

• General Practice Dentistry in Lawndale, CA
• Providers in Lawndale, 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 Oct 31, 2016; 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.