JOHN JUWON PARK (NPI# 1083866982) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1083866982 |
| Entity Type | Individual |
| Full Name | JOHN JUWON PARK |
| Credential | DMD |
| Practice Address |
4 Executive Park Dr Albany NY 12203 |
| Mailing Address |
255 Patroon Creek Blvd Apt 1405 Albany NY 12206-5019 |
| Practice Telephone | 3474088673 |
| Mailing Telephone | 3474088673 |
| Enumeration Date | 2008-10-22 |
| Last Update Date | 2018-05-17 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223P0221X |
Dentist Specialization: Pediatric Dentistry |
056491 | NY | Dental Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558718437 | John Park | Student in an Organized Health Care Education/Training Program | 8829 Hawthorne Ct, Ellicott City, MD 21043-3317 | 2016-05-19 |
| 1093134488 | John J. Park | Dentist | 5805 Silver Hill Rd Ste G, District Heights, MD 20747-1171 | 2014-04-14 |
| 1811265697 | John Park | Chiropractor | 2600 Walnut Ave Ste F, Tustin, CA 92780-7032 | 2011-12-07 |
| 1467759324 | John Park | Chiropractor | 256 N Sam Houston Pkwy E, Houston, TX 77060-2008 | 2011-02-11 |
| 1215168109 | John Ho Park | Radiology | 3901 Rainbow Blvd # Ms 4033, University of Kansas Medical Center, Kansas City, KS 66103-2937 | 2009-07-27 |
| 1063605988 | John Park | Case Manager/Care Coordinator | 600 Union Ave Apt B, Santa Maria, CA 93455-5327 | 2007-08-23 |
| 1144320292 | John Wonil Park | Anesthesiology | 7811 Courtney Manor Ln, Katy, TX 77494-6575 | 2006-09-25 |
| 1972538221 | John Park | Acupuncturist | 3815 1/2 Ocean View Blvd, Montrose, CA 91020-2125 | 2006-07-12 |
| 1205862075 | John Johghyun Park | Anesthesiology | 310 Egg Harbor Rd, Sewell, NJ 08080-1854 | 2006-06-24 |
| 1730181454 | John J Park | Dentist | 1079 Chambers St, Eugene, OR 97402-3706 | 2005-08-12 |
| Street Address |
4 EXECUTIVE PARK DR |
| City | ALBANY |
| State | NY |
| Zip Code | 12203 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154314805 | Thomas F. Fashouer | Specialist/Technologist | 4 Executive Park Dr, Albany Physical Therapy, Albany, NY 12203-3718 | 2005-08-29 |
| 1578045258 | Juwon Park Dmd PC | Dentist | 4 Executive Park Dr, Albany, NY 12203-3718 | 2018-08-30 |
| 1265936496 | Purificato Physical Therapy Pllc | Clinic/Center | 4 Executive Park Dr, Albany, NY 12203-3718 | 2018-03-21 |
| 1649799636 | James Nalbone, Md Pllc | Psychiatry & Neurology | 4 Executive Park Dr, Albany, NY 12203-3718 | 2017-09-12 |
| 1962883595 | Terence Hoyt | Counselor | 4 Executive Park Dr, Ste 201, Albany, NY 12203-3718 | 2015-06-09 |
| 1831529098 | Sphpma Crus Urology | Urology | 4 Executive Park Dr, Albany, NY 12203-3718 | 2013-11-25 |
| 1184979171 | Capital Region Urological Surgeons | Specialist | 4 Executive Park Dr, Albany, NY 12203-3718 | 2012-07-17 |
| 1164781837 | Phrances Blay Hinch | Nurse Practitioner | 4 Executive Park Dr, Albany, NY 12203-3718 | 2012-05-15 |
| 1942529631 | Subrata Mukherjee | Dentist | 4 Executive Park Dr, Albany, NY 12203-3718 | 2010-05-20 |
| 1720300296 | Andrea Berkowitz Lcsw | Social Worker | 4 Executive Park Dr, Albany, NY 12203-3718 | 2010-02-24 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720695885 | Claire Ellen Williams | Student in an Organized Health Care Education/Training Program | Advanced Therapy, Pllc, 10b Madison Avenue Extension, Albany, NY 12203 | 2020-09-23 |
| 1912551425 | Samaritan Hospital of Troy, New York | Nurse Practitioner | 1440 Western Avenue, Capital District Internal Medicine, Albany, NY 12203 | 2019-08-01 |
| 1205365640 | Esther Pearl Jackson | Counselor | 41 North Allen St. - Pine Hills Elementary School, Albany, NY 12203 | 2017-06-08 |
| 1558899591 | Diane Marie Wyatt | Social Worker | 1044 Western Ave, Albany, NY 12203 | 2017-06-02 |
| 1366980419 | Lessie Lynette Johnson | Social Worker | 40 N. Main Ave, St. Catherine's Center for Children, Albany, NY 12203 | 2017-02-09 |
| 1588108617 | Theresa Viola Dicroce | Physical Therapy Assistant | One Rapp Road, Advanced Therapy, P.l.l.c., Albany, NY 12203 | 2016-12-08 |
| 1366813818 | Eileen Nancy Nagy | Audiologist | 14 Columbia Circle, Suite 202, Albany, NY 12203 | 2015-10-09 |
| 1609242197 | Jaclyn Whitman | Specialist | 230 Washington Ave Extention, Albany, NY 12203 | 2015-08-19 |
| 1447657457 | Joyce Yvette Dewitt-parker | Psychologist | 260 Washington Ave. Ext., Corporate Plaza, Suite 101, Albany, NY 12203 | 2014-11-20 |
| 1023357373 | Meredith Gaucher | Physical Therapist | 1971 Western Ave Ste 100, Albany, NY 12203 | 2013-02-06 |
| Find all providers in zip 12203 | ||||
| Taxonomy Code | 1223P0221X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Pediatric Dentistry |
| An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336286517 | Jay Vaikuntam | Dentist | 155 Nw Hickory St, Albany, OR 97321-1724 | 2007-01-30 |
| 1528147394 | Steven Dwight Sample | Dentist | 2301 Lullwater Rd, Albany, GA 31707-3180 | 2006-11-03 |
| 1750378931 | Lawrence Alan Kotlow | Dentist | 340 Fuller Rd, Albany, NY 12203-3647 | 2005-10-03 |
| 1003423641 | Honeymint Pediatric Dentistry LLC | Dentist | 2350 14th Ave Se, Albany, OR 97322-6800 | 2020-09-28 |
| 1578045258 | Juwon Park Dmd PC | Dentist | 4 Executive Park Dr, Albany, NY 12203-3718 | 2018-08-30 |
| 1336531185 | Kenneth Steve Sellers Jr. | Dentist | 2301 Lullwater Rd, Albany, GA 31707-3180 | 2015-03-02 |
| 1972928158 | Eddie Ronald Fields Jr. | Dentist | 2301 Lullwater Rd, Albany, GA 31707-0001 | 2014-02-25 |
| 1922430487 | So & Valdez, A Professional Dental Corporatiom | Dentist | 847 San Pablo Ave, Albany, CA 94706-1602 | 2013-08-06 |
| 1881936441 | Pediatric Dentistry of Albany,pllc | Dentist | 980 Western Ave, Albany, NY 12203-2799 | 2013-03-21 |
| 1922338128 | Jeannette Marie Pope-ozimba | Dentist | 1505 W 3rd Ave, Ste A, Albany, GA 31707-3647 | 2010-01-11 |
| Find all providers in ALBANY | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.