Provider Demographics
NPI:1790936060
Name:JAMES PARK DDS, INC.
Entity Type:Organization
Organization Name:JAMES PARK DDS, INC.
Other - Org Name:CHUN AND PARK, D.D.S., INC.
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:KEONUK
Authorized Official - Last Name:PARK
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:714-870-6120
Mailing Address - Street 1:1950 SUNNYCREST DR
Mailing Address - Street 2:SUITE 3300
Mailing Address - City:FULLERTON
Mailing Address - State:CA
Mailing Address - Zip Code:92835-3638
Mailing Address - Country:US
Mailing Address - Phone:714-870-6120
Mailing Address - Fax:
Practice Address - Street 1:1950 SUNNYCREST DR
Practice Address - Street 2:SUITE 3300
Practice Address - City:FULLERTON
Practice Address - State:CA
Practice Address - Zip Code:92835-3638
Practice Address - Country:US
Practice Address - Phone:714-870-6120
Practice Address - Fax:714-870-6869
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-06
Last Update Date:2020-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Single Specialty