NPIMap

Organization Active NPI

Jin S Park DDS PC

Doing business as Paramount Dental Center

  • General Practice Dentistry
  • Paramount, CA
National Provider Identifier
1982733770
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
37476 Issued in CA
Legal business name
JIN S PARK DDS PC
Doing business as
Paramount Dental Center
Practice address
8428 Alondra Blvd
Paramount, CA 90723-4406
Phone
(562) 633-6566
Fax
(562) 633-3308
NPI assigned
Mar 5, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Jin S Park, DDSNPI 1710016514
Title
Ceo
Phone
(562) 633-6566

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 37476 CA Primary

Addresses

Primary practice location

8428 Alondra Blvd
Paramount, CA 90723-4406

Mailing address

8428 Alondra Blvd
Paramount, CA 90723-4406
Phone (562) 633-6566

Other identifiers 1

IdentifierTypeStateIssuer
B 37476MedicaidCA

Other names 1

  • Paramount Dental Center Doing business as

National Provider Directory

National Provider Directory

Locations

8428 Alondra Blvd
Paramount, CA 90723
Phone (562) 633-6566

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1173052800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1982733770",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8428 ALONDRA BLVD",
            "city": "PARAMOUNT",
            "state": "CA",
            "postal_code": "907234406",
            "telephone_number": "562-633-6566",
            "fax_number": "562-633-3308"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8428 ALONDRA BLVD",
            "city": "PARAMOUNT",
            "state": "CA",
            "postal_code": "907234406",
            "telephone_number": "562-633-6566",
            "fax_number": "562-633-3308"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JIN S PARK DDS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-05",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "PARK",
        "authorized_official_first_name": "JIN",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "562-633-6566",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "37476",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "B 37476",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Paramount Dental Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Paramount, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.