Active NPI
Cheryl Jonghee Park, DDS
- Prosthodontics
- Los Angeles, CA
National Provider Identifier
1841744638
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Prosthodontics
- License
- 62461
- Practice address
- 925 W. 34TH Street, Room 4363
Los Angeles, CA 90089 - Phone
- (213) 740-3612
- NPI assigned
- Aug 9, 2016
- Last updated
- Jul 6, 2018
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Prosthodontics | 1223P0700X | 62461 | CA | Primary |
Addresses
Primary practice location
925 W. 34TH Street, Room 4363
Los Angeles, CA 90089
Mailing address
925 W. 34TH Street, Room 4363
Los Angeles, CA 90089
Phone (213) 740-3612
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 62461 | CA | MD | Prosthodontist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1470700800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1530835200000",
"number": "1841744638",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "925 W. 34TH STREET, ROOM 4363",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "90089",
"telephone_number": "213-740-3612"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "925 W. 34TH STREET, ROOM 4363",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "90089",
"telephone_number": "213-740-3612"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PARK",
"first_name": "CHERYL",
"middle_name": "JONGHEE",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-08-09",
"last_updated": "2018-07-06",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0700X",
"taxonomy_group": "",
"desc": "Dentist, Prosthodontics",
"state": "CA",
"license": "62461",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Los Angeles, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.