Jake Park, DDS

General Practice Dentistry · Cleburne, TX

Individual Active NPI

NPI number 1801633730

Practice location

1661 W Henderson St
Cleburne, TX 76033-4230
Phone
(682) 317-5111

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NPI record

NPI
1801633730
Entity type
Individual (Type 1)
Enumeration date
July 9, 2024
Last updated
July 9, 2024
Certified
July 9, 2024
Sole proprietor
No

Specialties & taxonomy codes

TaxonomyCodeLicenseState
General Practice Dentistry Primary 1223G0001X 40767 TX

Mailing address

540 Coyote Canyon Way
Brea, CA 92821-3530
Phone
(714) 504-3579

Other practice locations (1)

  • 540 Coyote Canyon Way, Brea, CA 92821-3530 · (714) 788-7883

About Dr. Park

Jake Park, DDS is a healthcare provider registered in the NPI registry with the primary taxonomy General Practice Dentistry (code 1223G0001X). The practice location is 1661 W Henderson St, Cleburne, TX 76033-4230. The NPI number 1801633730 was assigned on July 9, 2024 and the record was last updated on July 9, 2024.

Dr. Park lists a license in the registry: #40767 (TX) 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 Jake Park, DDS?

The NPI number is 1801633730.

What is the phone number of Dr. Park?

The phone number listed for the practice location is (682) 317-5111.

Where is Dr. Park located?

1661 W Henderson St, Cleburne, TX 76033-4230.

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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