DR. JOSEPH WON-JOON PARK (NPI# 1205813227) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1205813227 |
| Entity Type | Individual |
| Full Name | DR. JOSEPH WON-JOON PARK |
| Credential | D.M.D |
| Practice Address |
1755 Saint Julian Pl Columbia SC 29204-2409 |
| Practice Telephone | 8032542972 |
| Practice Fax Number | 8037992151 |
| Mailing Telephone | 8032542972 |
| Mailing Fax Number | 8037992151 |
| Enumeration Date | 2005-12-30 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | X |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223S0112X |
Dentist Specialization: Oral and Maxillofacial Surgery |
3613 | SC | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| SC | ZX3613 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689156622 | Joseph Park | Social Worker | 100 N Bellefield Ave Ste 618, Pittsburgh, PA 15213-2600 | 2018-09-06 |
| 1205380854 | Joseph Soon Park | Student in an Organized Health Care Education/Training Program | 200 Campus Drive, Suite 3100, Hershey, PA 17033 | 2016-08-12 |
| 1700206869 | Joseph Choi Park | Otolaryngology | 601 N Caroline St # Street6, Baltimore, MD 21287-0006 | 2014-04-16 |
| 1700203700 | Joseph Park | Student in an Organized Health Care Education/Training Program | 1049 Rosedale Rd, Valley Stream, NY 11581-2704 | 2014-03-27 |
| 1760726574 | Joseph Park | Physical Therapist | 12465 Lewis Street, Suite 101, Garden Grove, CA 92840-4658 | 2012-11-16 |
| 1699916585 | Joseph Park | Dentist | 2411 Williams Dr Ste 111, Georgetown, TX 78628-3268 | 2009-03-23 |
| 1821139841 | Joseph Yip Park | Dentist | 2017 Queensguard Rd, Silver Spring, MD 20906-2032 | 2007-02-11 |
| 1891848412 | Joseph Park | Family Medicine | 3805 Main St Ste 112, The Colony, TX 75056-2853 | 2007-01-18 |
| 1194896373 | Joseph Park | Acupuncturist | 134 Howard St, Petaluma, CA 94952-2922 | 2006-11-10 |
| 1811079098 | Joseph M Park | Urology | 63 South 9th Street, Indiana, PA 15701 | 2006-10-19 |
| Street Address |
1755 SAINT JULIAN PL |
| City | COLUMBIA |
| State | SC |
| Zip Code | 29204-2409 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386699288 | Midlands Oral and Maxillofacial Surgery | Dentist | 1755 Saint Julian Pl, Columbia, SC 29204-2409 | 2006-05-23 |
| 1871570804 | David Brian Tevepaugh | Dentist | 1755 Saint Julian Pl, Columbia, SC 29204-2409 | 2005-12-30 |
| 1164409058 | Heath Mcalvin Stewart | Dentist | 1755 Saint Julian Pl, Columbia, SC 29204-2409 | 2005-12-30 |
| 1518944404 | James Lemon | Dentist | 1755 Saint Julian Pl, Columbia, SC 29204-2409 | 2005-12-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992215149 | Ricardo Colon II | Registered Nurse | 3000 Hampton Street, Columbia, SC 29204 | 2017-10-02 |
| 1780113522 | Carla Star Noe | Registered Nurse | Sc Department of Health and Environmental Control, 2100 Bull Street, Collumbia, SC 29204 | 2017-06-06 |
| 1124568514 | Kristy L Thompson | Nurse Practitioner | 1655 Bernardin Ave Ste 240, Columbia, SC 29204 | 2017-03-03 |
| 1982052031 | Harold Eugene Cook Iv | Podiatrist | 1730 St Julian Place, Columbia, SC 29204 | 2016-05-31 |
| 1851748974 | Shaquita Banks | Counselor | 1810 Allen Benedict Ct, A1, Columbia, SC 29204 | 2016-05-18 |
| 1265804835 | Premier Care, LLC | Case Management | 2712 Middleburg Drive, Suite 206, Columbia, SC 29204 | 2015-10-22 |
| 1023492287 | Shamiquia N. Mcpherson | Counselor | 1627 Auburn St., Columbia, SC 29204 | 2015-07-16 |
| 1285028449 | The Columbia Free Medical Clinic, Inc. | Clinic/Center | 1875 Harden Street, Columbia, SC 29204 | 2015-03-26 |
| 1629473459 | Leslie Wilson | Counselor | 2323 Lady Street, Columbia, SC 29204 | 2014-10-22 |
| 1053728683 | Candyce Sutton | Social Worker | 1135 Carter Street, Columbia, SC 29204 | 2014-07-15 |
| Find all providers in zip 29204 | ||||
| Taxonomy Code | 1223S0112X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Oral and Maxillofacial Surgery |
| The specialty of dentistry which includes the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740810845 | Akeso Columbia Office LLC | Dentist | 6798 Oak Hall Ln Ste A-1, Columbia, MD 21045-4892 | 2020-01-17 |
| 1679809958 | Mathew K Woodward | Dentist | 5397 Twin Knolls Rd Ste 18, Columbia, MD 21045-3256 | 2009-10-21 |
| 1679730709 | Antoine Gerard Johnson | Dentist | 8860 Columbia 100 Pkwy Ste 308, Columbia, MD 21045-2298 | 2008-05-16 |
| 1497829311 | Darren Richard Cross | Dentist | 611 Oneil Ct, Columbia, SC 29223-7656 | 2006-11-20 |
| 1427121078 | Joseph John Krupa IIi | Dentist | 3304 Forest Dr, Columbia, SC 29204-4024 | 2006-11-15 |
| 1194748285 | Paul Edward Cullum | Dentist | 105 Berrywood Dr, Columbia, TN 38401-6409 | 2006-07-26 |
| 1508885682 | Michael Illar Muul | Dentist | 6798 Oak Hall Ln, Suite A1, Columbia, MD 21045-4892 | 2006-07-19 |
| 1952353732 | James Winston Strider Jr. | Dentist | 9310 Two Notch Road, Columbia, SC 29223 | 2006-05-17 |
| 1952376964 | Timothy Thomas Coyle | Dentist | 3015 S Providence Rd, Suite 5, Columbia, MO 65203 | 2006-02-22 |
| 1497720841 | George Alan Hurwitz | Dentist | 10782 Hickory Ridge Rd, Columbia, MD 21044-3646 | 2006-02-21 |
| Find all providers in COLUMBIA | ||||
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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.