Jongwoo Joseph Park, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

37096 Issued in TX

Practice address

700 Alma Dr Ste 109
Plano, TX 75075-8800

Phone

(972) 423-6804

NPI assigned

Feb 26, 2019

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

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.

• Nexden LLC

  • Dental Clinic/Center
  • Plano, TX
  • NPI 1740995208
  NPD Authorized official
• Kim & Choi Dental P C

  • General Practice Dentistry
  • Plano, TX
  • NPI 1023300043
  NPD

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

{
    "created_epoch": "1551139200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633564800000",
    "number": "1770040644",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 ALMA DR STE 109",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750758800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 ALMA DR STE 109",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750758800",
            "telephone_number": "972-423-6804"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "JONGWOO",
        "middle_name": "JOSEPH",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-02-26",
        "last_updated": "2021-10-07",
        "certification_date": "2021-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "37096",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Park Clinic of Manual Medicine, Inc.
• Park Ventura Endoscopy Center, LLC
• Park Way Eye Care, PLLC
• David I Park, M.D.
• Jangwon Park, D.C.
• Sun Myung Park
• Parker Dental PA
• Parker Integrated Medical and Wellness, PLLC.
• Evelyn Parker-Gaspard, PHD
• Breanna Parker

• General Practice Dentistry in Plano, TX
• Providers in Plano, TX by specialty
• General Practice Dentistry in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2021; 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.