JAE HONG PARK (NPI# 1336649573) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1336649573 |
| Entity Type | Individual |
| Full Name | JAE HONG PARK |
| Credential | DMD |
| Practice Address |
1400 Pelham Pkwy S Bronx NY 10461-1138 |
| Mailing Address |
1 North 4th Pl 4i Brooklyn NY 11249 |
| Practice Telephone | 2142287043 |
| Mailing Telephone | 2142287043 |
| Enumeration Date | 2018-02-14 |
| Last Update Date | 2020-09-03 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223P0221X |
Dentist Specialization: Pediatric Dentistry |
061100 | NY | Dental Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386110781 | Jae H Park | Dentist | 1637 Admiral Taussig Blvd, Norfolk, VA 23511-2803 | 2018-10-23 |
| 1720506314 | Jae Y Park | Registered Nurse | 1103 10th St Nw, Rochester, MN 55901-1756 | 2017-09-02 |
| 1861649881 | Jae Hyun Park | Acupuncturist | 3020 Wilshire Blvd Ste 222, Los Angeles, CA 90010 | 2008-08-20 |
| 1811065238 | Jae Hyun Park | Dentist | 3155 W Indian School Rd, Western Dental Orthodontic Office, Phoenix, AZ 85017-4035 | 2006-12-01 |
| 1700977543 | Jae Ho Park | Dentist | 3123 W Olympic Blvd, Los Angeles, CA 90006-2462 | 2006-09-27 |
| 1144329723 | Jae H Park | Chiropractor | 4840 Irvine Blvd, #203, Irvine, CA 92620-1962 | 2006-09-21 |
| 1780621805 | Jae O Park | Internal Medicine | 14455 Sw Allen Blvd, Suite 101, Beaverton, OR 97005-4428 | 2006-05-31 |
| 1699750182 | Jae Y Park | Pharmacist | 3307 W Pico Bl, Los Angeles, CA 90019-4530 | 2005-12-07 |
| 1285109504 | Jae Park | Acupuncturist | 320 Ward Ave Ste 205, Honolulu, HI 96814-4017 | 2018-10-12 |
| 1750819652 | Jae Ho Park Sr. | Pharmacist | 254 N Western Ave, Los Angeles, CA 90004-4108 | 2017-05-23 |
| Street Address |
1400 PELHAM PKWY S |
| City | BRONX |
| State | NY |
| Zip Code | 10461-1138 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417942202 | Hale I Perlmutter | Physician Assistant | 1400 Pelham Pkwy S, Building 1 Psychiatry, Bronx, NY 10461-1138 | 2005-09-16 |
| 1992305213 | Heesun Huh | Pharmacist | 1400 Pelham Pkwy S, Bronx, NY 10461-1138 | 2020-10-27 |
| 1366059461 | Lifan Liang | Student in an Organized Health Care Education/Training Program | 1400 Pelham Pkwy S, Bronx, NY 10461-1197 | 2020-09-23 |
| 1891301792 | Felipe Jorge Simoes Jones | Student in an Organized Health Care Education/Training Program | 1400 Pelham Pkwy S, Jacobi Medical Center, Bronx, NY 10461 | 2020-09-17 |
| 1700491875 | Amr Walid Aljaerh | Student in an Organized Health Care Education/Training Program | 1400 Pelham Pkwy S, Bronx, NY 10461-1138 | 2020-09-15 |
| 1669087508 | Ahmad Anjum | Student in an Organized Health Care Education/Training Program | 1400 Pelham Pkwy S, Bronx, NY 10461-1197 | 2020-09-08 |
| 1144831744 | Paras Malik | Student in an Organized Health Care Education/Training Program | 1400 Pelham Pkwy S, Bronx, NY 10461-1197 | 2020-08-17 |
| 1508477167 | Maria Gabriela Rubianes Guerrero | Student in an Organized Health Care Education/Training Program | 1400 Pelham Pkwy S, Bronx, NY 10461-1138 | 2020-08-16 |
| 1215548763 | Sneha Nandy | Student in an Organized Health Care Education/Training Program | 1400 Pelham Pkwy S, Bronx, NY 10461-1197 | 2020-08-10 |
| 1801406368 | Ajita Naik | Student in an Organized Health Care Education/Training Program | 1400 Pelham Pkwy S, Bronx, NY 10461-1197 | 2020-08-08 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427665975 | Zhanna Kleynerman | Pharmacist | R&a Drugs Inc, 2562 Est Tremont Ave, Bronx, NY 10461 | 2020-09-29 |
| 1245867738 | Dalia Duzdar | Student in an Organized Health Care Education/Training Program | 1400 Pelham Pkwy S Building 6, Suite B125, Bronx, NY 10461 | 2020-03-24 |
| 1306486667 | Alvin Antony Mathew | Physical Therapist | 1500 Blondell Ave., Bronx, NY 10461 | 2020-01-14 |
| 1295374007 | Felicia Bowman | Peer Specialist | 55 Westchester Square Bronx, 55 Westchester Square Bronx, Bronx, NY 10461 | 2019-12-26 |
| 1477191161 | Todd Benevento Jr. | Physical Therapist | 1250 Waters Place Tower One 10th Floor, Bronx, NY 10461 | 2019-12-13 |
| 1073173845 | Harriet Sarpong-blankson | Pharmacist | Jack D Weiler Hospital, 1825 Eastchester Road, Bronx, NY 10461 | 2019-06-14 |
| 1396300166 | Victoria Sliva | Psychologist | 1400 Pelham Pkwy S Bldg 19w, Bldg 1, 9w, Bronx, NY 10461 | 2019-05-07 |
| 1538723366 | Shuai Wang | Student in an Organized Health Care Education/Training Program | 1400 Pelham Parkway South Jacobi Medical Center, Bronx, NY 10461 | 2019-04-26 |
| 1457810079 | Morpheus Sleep Solutions Inc | Durable Medical Equipment & Medical Supplies | 3004 Middletown Road, Lower Level Unit 1, Bronx, NY 10461 | 2019-03-13 |
| 1922565118 | Metro Care Management LLC | Case Management | 2481 Rowe St, Bronx, NY 10461 | 2019-02-25 |
| Find all providers in zip 10461 | ||||
| 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 |
|---|---|---|---|---|
| 1689178873 | Amanda Etwaria Brijlall | Dentist | 2723 Eastchester Rd, Bronx, NY 10469-5922 | 2018-03-21 |
| 1295275220 | Gun Hill Dental PC | Dentist | 301 E Gun Hill Rd, Bronx, NY 10467-2269 | 2017-02-23 |
| 1821400300 | Danielle Lombardi | Dentist | 1248 Crosby Ave, Bronx, NY 10461-6130 | 2014-06-02 |
| 1235567488 | Mojdeh Faraz | Dentist | 1400 Pelham Parkway South, Jacobi Medical Center, Bronx, NY 10461 | 2013-10-25 |
| 1679805733 | Rima Parikh | Dentist | 2750 Fish Ave, 2nd Fl, Bronx, NY 10469-5519 | 2010-01-31 |
| 1386767119 | Robert William Frankel | Dentist | 3317 Bainbridge Ave, Bronx, NY 10467-2801 | 2007-04-08 |
| 1104908904 | Jayati C Bhattacharyya | Dentist | 1516 Jarret Pl, Suite 100, Bronx, NY 10461-2607 | 2006-10-20 |
| 1801864848 | Varsha Divecha Shah | Dentist | 3005 Grand Concourse, Pediatric Dentist, Bronx, NY 10468-1428 | 2006-03-08 |
| 1972009959 | Leila Hazavei | Dentist | 111 East 210th Street, Bronx, NY 10467 | 2018-03-30 |
| 1215430327 | Kevin Zhang | Dentist | 1400 Pelham Pkwy S, Bronx, NY 10461-1138 | 2018-03-14 |
| Find all providers in BRONX | ||||
Please comment or provide details below to improve the information on JAE HONG PARK.
| 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.