Jinwoo Park, D.D.S.

Primary specialty

DentistTaxonomy code 122300000X

License

G1-0001310 Issued in DE

Practice address

2601 Annand Dr
#18
Wilmington, DE 19808-3719

Phone

(917) 407-1216

NPI assigned

Jul 26, 2008

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

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.

• Milltown Dental LLC

  • Dentist
  • Wilmington, DE
  • NPI 1659745941
  NPD (past) Authorized official

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

{
    "created_epoch": "1217030400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1448323200000",
    "number": "1831354091",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "602 BRILL CT",
            "city": "NEWARK",
            "state": "DE",
            "postal_code": "197113448",
            "telephone_number": "917-407-1216"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2601 ANNAND DR",
            "address_2": "#18",
            "city": "WILMINGTON",
            "state": "DE",
            "postal_code": "198083719",
            "telephone_number": "917-407-1216"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "JINWOO",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-07-26",
        "last_updated": "2015-11-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "DE",
            "license": "G1-0001310",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kurren Kumar Parida, MD
• Katrina Reapor Chu Paris, DPT
• Emily Michael Pariseau, PHD
• Katie Parisio, D.O.
• Christopher Park, LCSW
• Kiersten Park, MS, LAT, ATC
• Kwang H Park, PHARM. D.
• Seoyeon Park
• Siobhan L Park, PA-C
• Angela Parker, M.A

• Dentist in Wilmington, DE
• Providers in Wilmington, DE by specialty
• Dentist in Delaware

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 24, 2015; 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.