Chan Hee Park, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

106426 Issued in CA

Practice address

1812 Linda Vista Ave
Pasadena, CA 91103-1149

Phone

(213) 703-3481

NPI assigned

Aug 5, 2021

Sex

Female

Sole proprietor

No

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

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1628121600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628121600000",
    "number": "1811661648",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1812 LINDA VISTA AVE",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911031149",
            "telephone_number": "213-703-3481"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1812 LINDA VISTA AVE",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911031149",
            "telephone_number": "213-703-3481"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "CHAN HEE",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-05",
        "last_updated": "2021-08-05",
        "certification_date": "2021-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "106426",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sioneh Paria, FNP
• Amish Ketan Parikh
• Chanell Ashley Paris, AMFT, APCC
• Elika Parivar
• Carine Park
• David Chang Hoon Park
• Evan Park
• Helen Y Park, PSY.D.
• Hyejin Park, MA
• Jasmine Myso Park, MD

• General Practice Dentistry in Pasadena, CA
• Providers in Pasadena, 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 Aug 5, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.