Holly Hyunjung Park-Nah, DDS

Primary specialty

EndodonticsTaxonomy code 1223E0200X

License

DN30260 Issued in FL

Practice address

2797 Saint Johns Bluff Rd S
Jacksonville, FL 32246-3703

Phone

(904) 966-4560

NPI assigned

Jun 14, 2010

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

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": "1276473600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762819200000",
    "number": "1881915858",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2797 SAINT JOHNS BLUFF RD S",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322463703",
            "telephone_number": "904-966-4560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2797 SAINT JOHNS BLUFF RD S",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322463703",
            "telephone_number": "904-966-4560"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK-NAH",
        "first_name": "HOLLY",
        "middle_name": "HYUNJUNG",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-06-14",
        "last_updated": "2025-11-11",
        "certification_date": "2025-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "KY",
            "license": "8597",
            "primary": false
        },
        {
            "code": "1223E0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Endodontics",
            "state": "FL",
            "license": "DN30260",
            "primary": true
        },
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "OR",
            "license": "D10948",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Park & King Pharmacy Inc (Park and King Pharmacy Inc)
• Park Avenue Heart and Vascular Center LLC
• Debra M Park Burdon, RT
• Park Homecare Management,Inc (Fletcher's Home Care)
• Park Ridge Nursing & Rehab Center LLC
• Charles Sue Park, MD
• Chin W. Park
• Kwang SE Park, M.D.
• Lauren Park
• Lucienne Park, DMD

• Endodontics in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Endodontics in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2025; 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.