Sihyun Park, D.D.S.

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

060392 Issued in NY

Practice address

121 E 31St St
Apt 4C
New York, NY 10016-6834

Phone

(917) 854-1510

NPI assigned

Jul 7, 2015

Sex

Male

Sole proprietor

Yes

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 and National Provider Directory roles.

• Thundercat Pediatric Dentistry PLLC

  • Dental Clinic/Center
  • Brooklyn, NY
  • NPI 1912883992
  NPD Authorized official

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

{
    "created_epoch": "1436227200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565568000000",
    "number": "1811370034",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 WHISTLER CT UNIT 402",
            "city": "SARATOGA SPRINGS",
            "state": "NY",
            "postal_code": "128668426",
            "telephone_number": "917-854-1510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "121 E 31ST ST",
            "address_2": "APT 4C",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100166834",
            "telephone_number": "917-854-1510"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "SIHYUN",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-07-07",
        "last_updated": "2019-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "NY",
            "license": "060392",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Seon Jung Shelly Park
• Seoyoun Park
• Seung K. Park, LAC, LMT
• Sharon Park, NP
• Si Yun Park
• Sin Yeong Park
• Sinyoung Park
• So-Eun Park
• Song Park, L.A.C
• Songee Park

• Pediatric Dentistry in New York, NY
• Providers in New York, NY by specialty
• Pediatric Dentistry in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2019; 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.