Jung Joo Park, D.M.D.

Primary specialty

DentistTaxonomy code 122300000X

License

22DI02549600 Issued in NJ

Practice address

460 Sylvan Ave FL 1
Englewood Cliffs, NJ 07632-2943

Phone

(201) 608-7000

NPI assigned

Oct 2, 2013

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": "1380672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1380672000000",
    "number": "1861829129",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "460 SYLVAN AVE FL 1",
            "city": "ENGLEWOOD CLIFFS",
            "state": "NJ",
            "postal_code": "076322943",
            "telephone_number": "201-608-7000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "460 SYLVAN AVE FL 1",
            "city": "ENGLEWOOD CLIFFS",
            "state": "NJ",
            "postal_code": "076322943",
            "telephone_number": "201-608-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "JUNG JOO",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-10-02",
        "last_updated": "2013-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NJ",
            "license": "22DI02549600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bosco Seongyeol Park, PT, DPT
• Cheonil Park, DC
• Chonghyo Thomas Park, M.D.
• Ducksoon Park, D.C.
• Hai Sun Park, M.D.
• Seo Hyun Park
• Pascack Valley Medical Care PC
• Pathway Personal Counseling
• Paul Kyungho Cho MD LLC
• PCS Consultant LLC

• Dentist in Englewood Cliffs, NJ
• Providers in Englewood Cliffs, NJ by specialty
• Dentist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2013; 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.