Jung Won Park, DDS

Dentist · Tyler, TX

Individual Active NPI

NPI number 1043983364

Practice location

212 Old Grande Blvd Ste B224
Tyler, TX 75703-4277
Phone
(903) 509-0505

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NPI record

NPI
1043983364
Entity type
Individual (Type 1)
Enumeration date
August 2, 2021
Last updated
August 2, 2021
Certified
August 2, 2021
Sole proprietor
No

Specialties & taxonomy codes

TaxonomyCodeLicenseState
Dentist Primary 122300000X 37630 TX

Mailing address

11 S Mill St Ste 200
New Castle, PA 16101-3680
Phone
(225) 324-2493

About Dr. Park

Jung Won Park, DDS is a healthcare provider registered in the NPI registry with the primary taxonomy Dentist (code 122300000X). The practice location is 212 Old Grande Blvd Ste B224, Tyler, TX 75703-4277. The NPI number 1043983364 was assigned on August 2, 2021 and the record was last updated on August 2, 2021.

Dr. Park lists a license in the registry: #37630 (TX) for Dentist. License numbers are self-reported to NPPES; verify them with the state licensing board.

Frequently asked questions

What is the NPI number of Jung Won Park, DDS?

The NPI number is 1043983364.

What is the phone number of Dr. Park?

The phone number listed for the practice location is (903) 509-0505.

Where is Dr. Park located?

212 Old Grande Blvd Ste B224, Tyler, TX 75703-4277.

What is the taxonomy code for Dr. Park?

The primary taxonomy code is 122300000X – Dentist.

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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