Yong Suel Park, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

11859 Issued in CT

Practice address

2452 Black Rock Tpke Ste 12
Fairfield, CT 06825-2417

Phone

(203) 372-9848

NPI assigned

Jul 28, 2017

Last updated

Sep 30, 2026By the provider in NPPES

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Divine Dentistry PC

  dba Divine Dentistry at Fairfield

  • General Practice Dentistry
  • Fairfield, CT
  • NPI 1427756949
  NPD (past)
• Neat Dental PC

  • Dental Clinic/Center
  • Bridgeport, CT
  • NPI 1790541969
  NPD (past)

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

{
    "created_epoch": "1501200000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790726400000",
    "number": "1972027225",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 195",
            "city": "VERNON",
            "state": "NJ",
            "postal_code": "074620195",
            "telephone_number": "716-449-3067"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2452 BLACK ROCK TPKE STE 12",
            "city": "FAIRFIELD",
            "state": "CT",
            "postal_code": "068252417",
            "telephone_number": "203-372-9848"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "YONG",
        "middle_name": "SUEL",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-07-28",
        "last_updated": "2026-09-30",
        "certification_date": "2026-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CT",
            "license": "11859",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Paradigm Medical Care, LLC
• Jonathan Paramo, MD
• Ashley Jordan Parent
• Harvey Michael Paris, LCSW
• Elisse Park, MD
• Parklane Opticians of Fairfield,Inc
• Lauren Parnoff, BCBA
• Pasquale J. Dematteo, D.O., P.C. (Fairfield Family Medical Care)
• Jo-Anne Passalacqua, M.D.
• Carol A Passmore, LPC

• General Practice Dentistry in Fairfield, CT
• Providers in Fairfield, CT by specialty
• General Practice Dentistry in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2026; 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.