BYUNGCHUL PARK (NPI# 1316317092) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1316317092 |
| Entity Type | Individual |
| Full Name | BYUNGCHUL PARK |
| Credential | D.D.S. |
| Practice Address |
258 S Frontage Rd New London CT 06320-2641 |
| Practice Telephone | 8604373462 |
| Mailing Telephone | 8604373462 |
| Enumeration Date | 2015-10-06 |
| Last Update Date | 2015-10-06 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
011494 | CT | Dental Providers |
| Street Address |
258 S FRONTAGE RD |
| City | NEW LONDON |
| State | CT |
| Zip Code | 06320-2641 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629364997 | New London Dental Care, LLC | Dentist | 258 S Frontage Rd, New London, CT 06320-2641 | 2011-06-24 |
| 1003384975 | Sung Woo Cho | Dentist | 258 S Frontage Rd, New London, CT 06320-2641 | 2018-11-08 |
| 1649795964 | Gi Tae Kwon | Dentist | 258 S Frontage Rd, New London, CT 06320-2641 | 2017-08-08 |
| 1255708830 | Soo Ji Lee | Dentist | 258 S Frontage Rd, New London, CT 06320-2641 | 2015-08-30 |
| 1891059465 | Vipasha Desai | Dentist | 258 S Frontage Rd, New London, CT 06320-2641 | 2012-06-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942824891 | Shilpi Jain | Physical Therapist | 31 Vauxhall Street, Beechwood Post Accute, Transitional, New London, CT 06320 | 2020-06-05 |
| 1174009641 | Catherine Hinojosa | Nurse Practitioner | 1 Shaws Cove, New London, CT 06320 | 2018-07-17 |
| 1043668320 | Cultivate & Grow Inc. | Counselor | 302 State St Suite 307, New London, CT 06320 | 2016-05-27 |
| 1295137263 | Jacqueline Durnell | Registered Nurse | 15 Mohegan Drive, Us Coast Guard Academy Regional Clinic, New London, CT 06320 | 2014-09-22 |
| 1922427541 | Corina Vendetto | Registered Nurse | 245 Shaw St., New London, CT 06320 | 2014-04-10 |
| 1912329962 | Janelle Posey-green | Social Worker | 302 State St., Suite 201, New London, CT 06320 | 2014-01-10 |
| 1750622692 | Cynthia Mitchell | Social Worker | 65b Michael Rd, New London, CT 06320 | 2013-03-01 |
| 1518254507 | Simon J Shapiro | Physical Medicine & Rehabilitation | 190 Howard Avenue, New London, CT 06320 | 2011-06-29 |
| 1184876708 | Jane P Genido-trujillo | Nurse Practitioner | 270 Mohegan Ave., Student Health Services, New London, CT 06320 | 2008-10-14 |
| 1932356284 | Gerard Joseph Ventura | Dentist | 21 Montauk Ave., Suite 102, New London, CT 06320 | 2008-08-19 |
| Find all providers in zip 06320 | ||||
| Taxonomy Code | 1223G0001X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | General Practice |
| A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. |
| Notes: Source: Academy of General Dentistry |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548502438 | Elliot Harold Kimmel | Dentist | 27 Broad St, New London, CT 06320-5973 | 2013-03-19 |
| 1851569768 | Gregory P. Gutgsell Dds & Darren M Phipps Dds, Prof Assn | Dentist | 125 Newport Road, New London, NH 03257 | 2008-02-13 |
| 1134248651 | Drs. Matyas & Matyas | Dentist | 4 Shaws Cv Ste 202, New London, CT 06320-4956 | 2007-03-28 |
| 1245364694 | Charles Clayton Loberg | Dentist | 201 Wisconsin Street, New London, WI 54961-1171 | 2007-03-16 |
| 1922130160 | Charles C. Loberg D.d.s.,s.c. | Dentist | 201 Wisconsin St, New London, WI 54961-1171 | 2007-03-12 |
| 1134272511 | Paul Hanna D.m.d., P.C. | Dentist | 461 Ocean Ave, New London, CT 06320-4502 | 2007-01-19 |
| 1669530135 | Mary Wicenski | Dentist | 27 Newport Road, New London, NH 03257-1017 | 2006-12-05 |
| 1891871273 | John Allen | Dentist | 464 Montauk Ave, New London, CT 06320-4606 | 2006-10-28 |
| 1255438768 | John Leonard Difederico | Dentist | 195 Vauxhall St, New London, CT 06320 | 2006-09-19 |
| 1780799189 | Mark Christ Pothitakis | Dentist | 107 E Toothache Dr, New London, IA 52645-1141 | 2006-08-19 |
| Find all providers in NEW LONDON | ||||
| City | NEW LONDON |
| Zip Code | 06320 |
Please comment or provide details below to improve the information on BYUNGCHUL 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.