Si-Woon Park, DDS

Primary specialty

ProsthodonticsTaxonomy code 1223P0700X

License

0401410858 Issued in VA

Practice address

8320 Old Courthouse Rd
Suite 402
Vienna, VA 22182-3831

Phone

(703) 356-3970

Fax

(703) 356-3971

NPI assigned

Oct 3, 2007

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

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

{
    "created_epoch": "1191369600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1191369600000",
    "number": "1770770786",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8320 OLD COURTHOUSE RD",
            "address_2": "SUITE 402",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221823831",
            "telephone_number": "703-356-3970",
            "fax_number": "703-356-3971"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8320 OLD COURTHOUSE RD",
            "address_2": "SUITE 402",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221823831",
            "telephone_number": "703-356-3970",
            "fax_number": "703-356-3971"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "SI-WOON",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-10-03",
        "last_updated": "2007-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0700X",
            "taxonomy_group": "",
            "desc": "Dentist, Prosthodontics",
            "state": "VA",
            "license": "0401410858",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Makenna Paradis, PT, DPT
• Charles Parente, M.D.
• Haoyun W Park, L.AC
• James K Park, M.D., PH.D.
• Jesoon Helmsley Park, L.AC
• Su Ji Park
• Sung-Jun Park, D.C
• Yunsoo Park, PH.D.
• Latosha Parker
• Annalisa M. Parks, M.D.

• Prosthodontics in Vienna, VA
• Providers in Vienna, VA by specialty
• Prosthodontics in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2007; 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.