James Keonuk Park, D.D.S.

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

57027 Issued in CA

Practice address

1950 Sunnycrest Dr
Suite 3300
Fullerton, CA 92835-3638

Phone

(714) 870-6120

Fax

(714) 870-6869

NPI assigned

Jan 30, 2007

Last updated

Jul 7, 2008By 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 2

Addresses

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

• James Park DDS, Inc.

  dba Sunny Hills Pediatric Dentistry

  • Pediatric Dentistry
  • Fullerton, CA
  • NPI 1790936060
  NPD (past) Authorized official

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

{
    "created_epoch": "1170115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1215388800000",
    "number": "1780721852",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1950 SUNNYCREST DR",
            "address_2": "SUITE 3300",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928353638",
            "telephone_number": "714-870-6120",
            "fax_number": "714-870-6869"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1950 SUNNYCREST DR",
            "address_2": "SUITE 3300",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928353638",
            "telephone_number": "714-870-6120",
            "fax_number": "714-870-6869"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "JAMES",
        "middle_name": "KEONUK",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-30",
        "last_updated": "2008-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "NJ",
            "license": "22DI02283700",
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "CA",
            "license": "57027",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• David J Park, M.D.
• Eugene Park, L.AC.
• Gene Hyounglin Park, D.D.S., M.S.
• Heejin Park
• Jaeyong Park, LAC
• Janice Hyejin Park, PHARMD
• Jennifer Park
• Ji Yong Park, DDS
• Jin Woo Park, AC
• Joanne Hyewon Park

• Pediatric Dentistry in Fullerton, CA
• Providers in Fullerton, CA by specialty
• Pediatric Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2008; 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.