Jae Hong Park
Dentist (Pediatric Dentistry)

Address: 1400 Pelham Pkwy S, Bronx, NY 10461-1138
Phone: 2142287043

Jae Hong Park (NPI# 1336649573) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider Identifier (NPI) 1336649573
Entity Type Individual
Full Name Jae Hong Park
Credential DMD
Gender Male
Practice Address 1400 Pelham Pkwy S
Bronx
NY 10461-1138
Practice Telephone 2142287043
Mailing Address 1 North 4th Pl
4i
Brooklyn
NY 11249
Mailing Telephone 2142287043
Sole Proprietor No, this individual is not a Sole Proprietor
Enumeration Date 2018-02-14
Last Update Date 2020-09-03

Taxonomy Codes

Primary Taxonomy Classification Taxonomy Group License Number State
Yes 1223P0221X Dentist · Pediatric Dentistry Dental Providers 061100 NY

Providers with the same name

NPI Name Taxonomy Address Enumeration
1386110781 Jae H Park Dentist 1637 Admiral Taussig Blvd, Norfolk, VA 23511-2803 2018-10-23
1720506314 Jae Y Park Registered Nurse 1103 10th St Nw, Rochester, MN 55901-1756 2017-09-02
1861649881 Jae Hyun Park Acupuncturist 3020 Wilshire Blvd Ste 222, Los Angeles, CA 90010 2008-08-20
1811065238 Jae Hyun Park Dentist 3155 W Indian School Rd, Western Dental Orthodontic Office, Phoenix, AZ 85017-4035 2006-12-01
1023199924 Jae Young Park Acupuncturist 300 W Hospital Rd Bldg 3006th, Interdisciplinary Pain Management Center, Fort Gordon, GA 30905-5741 2006-10-18
1700977543 Jae Ho Park Dentist 3123 W Olympic Blvd, Los Angeles, CA 90006-2462 2006-09-27
1144329723 Jae H Park Chiropractor 4840 Irvine Blvd, #203, Irvine, CA 92620-1962 2006-09-21
1780621805 Jae O Park Internal Medicine 14455 Sw Allen Blvd, Suite 101, Beaverton, OR 97005-4428 2006-05-31
1699750182 Jae Y Park Pharmacist 3307 W Pico Bl, Los Angeles, CA 90019-4530 2005-12-07
1285109504 Jae Park Acupuncturist 320 Ward Ave Ste 205, Honolulu, HI 96814-4017 2018-10-12
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Taxonomy Information

Taxonomy Code 1223P0221X
Grouping Dental Providers
Classification Dentist
Specialization Pediatric Dentistry

Taxonomy Definition

An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs.
Notes: Source: Council on Dental Education and Licensure, American Dental Association

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1689178873 Amanda Etwaria Brijlall Dentist 2723 Eastchester Rd, Bronx, NY 10469-5922 2018-03-21
1821400300 Danielle Lombardi Dentist 1248 Crosby Ave, Bronx, NY 10461-6130 2014-06-02
1235567488 Mojdeh Faraz Dentist 1400 Pelham Parkway South, Jacobi Medical Center, Bronx, NY 10461 2013-10-25
1679805733 Rima Parikh Dentist 2750 Fish Ave, 2nd Fl, Bronx, NY 10469-5519 2010-01-31
1386767119 Robert William Frankel Dentist 3317 Bainbridge Ave, Bronx, NY 10467-2801 2007-04-08
1104908904 Jayati C Bhattacharyya Dentist 1516 Jarret Pl, Suite 100, Bronx, NY 10461-2607 2006-10-20
1801864848 Varsha Divecha Shah Dentist 3005 Grand Concourse, Pediatric Dentist, Bronx, NY 10468-1428 2006-03-08
1972009959 Leila Hazavei Dentist 111 East 210th Street, Bronx, NY 10467 2018-03-30
1215430327 Kevin Zhang Dentist 1400 Pelham Pkwy S, Bronx, NY 10461-1138 2018-03-14
1740718204 Daniele Michelle Orellana Dentist 1065 Southern Blvd, Bronx, NY 10459-2417 2017-05-30
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Office Location

Street Address 1400 PELHAM PKWY S
City BRONX
State NY
Zip Code 10461-1138

Providers in the same location

NPI Name Taxonomy Address Enumeration
1417942202 Hale I Perlmutter Physician Assistant 1400 Pelham Pkwy S, Building 1 Psychiatry, Bronx, NY 10461-1138 2005-09-16
1982290177 Shena Amanda Joseph Registered Nurse 1400 Pelham Pkwy S, Bronx, NY 10461-1197 2020-12-12
1871196329 Christian Pisco-esteva Nurse Practitioner 1400 Pelham Pkwy S, Bronx, NY 10461-1197 2020-11-18
1699377986 Nancy Nicaisse Nurse Practitioner 1400 Pelham Pkwy S, Bronx, NY 10461-1197 2020-11-11
1992305213 Heesun Huh Pharmacist 1400 Pelham Pkwy S, Bronx, NY 10461-1138 2020-10-27
1366059461 Lifan Liang Student in an Organized Health Care Education/Training Program 1400 Pelham Pkwy S, Bronx, NY 10461-1197 2020-09-23
1891301792 Felipe Jorge Simoes Jones Student in an Organized Health Care Education/Training Program 1400 Pelham Pkwy S, Jacobi Medical Center, Bronx, NY 10461 2020-09-17
1700491875 Amr Walid Aljareh Student in an Organized Health Care Education/Training Program 1400 Pelham Pkwy S, Bronx, NY 10461-1138 2020-09-15
1669087508 Ahmad Anjum Student in an Organized Health Care Education/Training Program 1400 Pelham Pkwy S, Bronx, NY 10461-1197 2020-09-08
1144831744 Paras Malik Student in an Organized Health Care Education/Training Program 1400 Pelham Pkwy S, Bronx, NY 10461-1197 2020-08-17
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1427665975 Zhanna Kleynerman Pharmacist R&a Drugs Inc, 2562 Est Tremont Ave, Bronx, NY 10461 2020-09-29
1245867738 Dalia Duzdar Student in an Organized Health Care Education/Training Program 1400 Pelham Pkwy S Building 6, Suite B125, Bronx, NY 10461 2020-03-24
1306486667 Alvin Antony Mathew Physical Therapist 1500 Blondell Ave., Bronx, NY 10461 2020-01-14
1295374007 Felicia Bowman Peer Specialist 55 Westchester Square Bronx, 55 Westchester Square Bronx, Bronx, NY 10461 2019-12-26
1477191161 Todd Benevento Jr. Physical Therapist 1250 Waters Place Tower One 10th Floor, Bronx, NY 10461 2019-12-13
1073173845 Harriet Sarpong-blankson Pharmacist Jack D Weiler Hospital, 1825 Eastchester Road, Bronx, NY 10461 2019-06-14
1396300166 Victoria Sliva Psychologist 1400 Pelham Pkwy S Bldg 19w, Bldg 1, 9w, Bronx, NY 10461 2019-05-07
1538723366 Shuai Wang Student in an Organized Health Care Education/Training Program 1400 Pelham Parkway South Jacobi Medical Center, Bronx, NY 10461 2019-04-26
1457810079 Morpheus Sleep Solutions Inc Durable Medical Equipment & Medical Supplies 3004 Middletown Road, Lower Level Unit 1, Bronx, NY 10461 2019-03-13
1922565118 Metro Care Management LLC Case Management 2481 Rowe St, Bronx, NY 10461 2019-02-25
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Competitor

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City BRONX
Zip Code 10461

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Dataset Information

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.