JUN GYU PARK, D.D.S., INC. (NPI# 1245742956) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1245742956 |
| Entity Type | Organization |
| Organization Name | JUN GYU PARK, D.D.S., INC. |
| Practice Address |
12372 Euclid St Garden Grove CA 92840-3308 |
| Practice Telephone | 7145391004 |
| Mailing Telephone | 7145391004 |
| Enumeration Date | 2017-11-03 |
| Last Update Date | 2017-12-17 |
| Authorized Official Name | DR. JUN GYU PARK (CEO) |
| Authorized Official Telephone | 7145391004 |
| Authorized Official Credential | DDS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QD0000X |
Clinic/Center Specialization: Dental |
101441 | CA | Ambulatory Health Care Facilities |
| Street Address |
12372 EUCLID ST |
| City | GARDEN GROVE |
| State | CA |
| Zip Code | 92840-3308 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972512838 | Youngjoon Kim | Dentist | 12372 Euclid St, Garden Grove, CA 92840-3308 | 2006-08-07 |
| 1851800072 | Jun Gyu Park | Dentist | 12372 Euclid St, Garden Grove, CA 92840-3308 | 2017-09-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588283808 | Kimberly Gaeta | Behavioral Analyst | 123935 Lewis Street, Ste 202, Garden Grove, CA 92840 | 2020-04-16 |
| 1396397170 | Rosa Cortez | Behavior Technician | 12443 Lewis Street, #201, Garden Grove, CA 92840 | 2019-07-12 |
| 1376005934 | Sekboppa Sor | Nurse Practitioner | An Lanh Free Clinic, 10861 Acacia Pkwy., Garden Grove, CA 92840 | 2019-04-03 |
| 1346730116 | Vinh Le Tran | Pharmacist | 12666 Brookhurst St. Suite 110, Garden Grove, CA 92840 | 2018-05-16 |
| 1841715232 | Scott R. Blair | Physician Assistant | 12828 Harbor Blvd Ste 200, Garden Grove, CA 92840 | 2017-08-07 |
| 1881049492 | Carmen Keally | Dietitian, Registered | 12602 9th St, Garden Grove, CA 92840 | 2016-05-02 |
| 1548688732 | House Call Medical Associates, Inc. | Internal Medicine | 12865 Main St Ste 105, Garden Grove, CA 92840 | 2014-04-03 |
| 1851733059 | Carly Ann Wade | Marriage & Family Therapist | 12755 Brookhurst St. Ste 116, Garden Grove, CA 92840 | 2013-07-29 |
| 1003159864 | Priyal Shah Ohri | Dentist | 10602 Chapman Ave, Suite 200, Garden Grove, CA 92840 | 2013-03-30 |
| 1770853244 | Joseph Pham | Pharmacist | 12001 Euclid St., Garden Grove, CA 92840 | 2011-12-30 |
| Find all providers in zip 92840 | ||||
| Taxonomy Code | 261QD0000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Dental |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558861138 | Vu Bui Dds, Inc | Clinic/Center | 10248 Westminster Ave, Garden Grove, CA 92843-4830 | 2018-02-20 |
| 1093183410 | Gene H Park Dds, Inc | Clinic/Center | 9240 Garden Grove Blvd Ste 1, Garden Grove, CA 92844-1400 | 2015-09-02 |
| 1730467044 | Lourenco Dds. Inc | Clinic/Center | 12112 Brookhurst Street, Suite 1, Garden Grove, CA 92840-2844 | 2011-08-03 |
| 1285762534 | Wai Chu, Dds., Inc | Clinic/Center | 12302 Garden Grove Blvd Ste 2, Garden Grove, CA 92843-1833 | 2007-03-01 |
| 1073656781 | Phil Trinh, Dds.,inc | Clinic/Center | 12302 Garden Grove Blvd Ste 1, Garden Grove, CA 92843-1833 | 2007-02-14 |
| 1205987070 | Hoa Quynh Duong D.d.s. & Yen Hai Duong D.d.s., Inc. | Clinic/Center | 13518 Harbor Blvd, A5, Garden Grove, CA 92843-3838 | 2007-01-16 |
| 1275010704 | Bao-chau Le Nguyen, D.d.s., P.C. | Clinic/Center | 14265 Brookhurst St, Garden Grove, CA 92843-4648 | 2018-07-26 |
| 1679081848 | Thayer Hussein Dds,inc | Clinic/Center | 13872 Harbor Blvd Ste 1a-3, Garden Grove, CA 92843-4041 | 2018-01-22 |
| 1376058123 | Andrade Dental Family, Inc. | Clinic/Center | 5885 Lampson Ave, Garden Grove, CA 92845-2007 | 2017-12-01 |
| 1689198806 | Seung Hwan Kim, Dds, Inc | Clinic/Center | 13252 Century Blvd Ste Q, Garden Grove, CA 92843-1257 | 2017-07-30 |
| Find all providers in GARDEN GROVE | ||||
| City | GARDEN GROVE |
| Zip Code | 92840 |
Please comment or provide details below to improve the information on JUN GYU PARK, D.D.S., INC..
| 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.