Jino Park, D.D.S

Primary specialty

DentistTaxonomy code 122300000X

License

62028 Issued in CA

Practice address

24950 Redlands Blvd Ste B
Loma Linda, CA 92354-4028

Phone

(909) 478-9777

NPI assigned

Feb 5, 2013

Sex

Male

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

Practice roles

Locations

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.

• Jino Park DDS Dental Corporation

  • Dental Clinic/Center
  • Loma Linda, CA
  • NPI 1164110151
  Medicare reassignment NPD Authorized official
• Jino Park DDS Inc

  • Dental Clinic/Center
  • Lake Forest, CA
  • NPI 1568092401
  NPD Authorized official

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

{
    "created_epoch": "1360022400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747785600000",
    "number": "1912246356",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "106 ROTUNDA",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926207325",
            "telephone_number": "909-969-3503"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24950 REDLANDS BLVD STE B",
            "city": "LOMA LINDA",
            "state": "CA",
            "postal_code": "923544028",
            "telephone_number": "909-478-9777"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "106 Rotunda",
            "address_purpose": "LOCATION",
            "city": "Irvine",
            "state": "CA",
            "postal_code": "926207325",
            "country_code": "US",
            "telephone_number": "909-969-3503",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "22611 Lake Forest Dr Ste C5",
            "address_purpose": "LOCATION",
            "city": "Lake Forest",
            "state": "CA",
            "postal_code": "926301700",
            "country_code": "US",
            "telephone_number": "909-969-3503",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PARK",
        "first_name": "JINO",
        "credential": "D.D.S",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-02-05",
        "last_updated": "2025-05-21",
        "certification_date": "2025-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "62028",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• David Jungmyoung Park
• Eujean Park
• Hee Chan Park, M.D.
• Hyeon Park
• Hyun Soo Park
• Ju an Park, MD
• Kimberly Park, MD
• Kyung Hyun Park, PHARM.D.
• Seong Hyun Park
• Shaun Park, M.D.

• Dentist in Loma Linda, CA
• Providers in Loma Linda, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 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.