Jay Park, DMD

General Practice Dentistry · Auburn, WA

Individual Active NPI

NPI number 1013581677

Practice location

1404 Lake Tapps Pkwy SE Ste a103
Auburn, WA 98092-8156
Phone
(253) 341-4973

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NPI record

NPI
1013581677
Entity type
Individual (Type 1)
Enumeration date
May 18, 2021
Last updated
May 18, 2021
Certified
May 18, 2021
Sole proprietor
Yes

Specialties & taxonomy codes

TaxonomyCodeLicenseState
General Practice Dentistry Primary 1223G0001X DE61164036 WA

Mailing address

12319 41st Street Ct E
Edgewood, WA 98372-7801
Phone
(931) 494-6959

About Dr. Park

Jay Park, DMD is a healthcare provider registered in the NPI registry with the primary taxonomy General Practice Dentistry (code 1223G0001X). The practice location is 1404 Lake Tapps Pkwy SE Ste a103, Auburn, WA 98092-8156. The NPI number 1013581677 was assigned on May 18, 2021 and the record was last updated on May 18, 2021.

Dr. Park lists a license in the registry: #DE61164036 (WA) for General Practice Dentistry. License numbers are self-reported to NPPES; verify them with the state licensing board.

Frequently asked questions

What is the NPI number of Jay Park, DMD?

The NPI number is 1013581677.

What is the phone number of Dr. Park?

The phone number listed for the practice location is (253) 341-4973.

Where is Dr. Park located?

1404 Lake Tapps Pkwy SE Ste a103, Auburn, WA 98092-8156.

What is the taxonomy code for Dr. Park?

The primary taxonomy code is 1223G0001X – General Practice Dentistry.

Is this information correct?

All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.

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