Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1669907663 Individual Practitioner Male Practitioner

Dr. Jun Sup Park , DDS

Dentist • Downey, CA

Professional Overview & Biography Verified Profile Summary

Dr. Jun Sup Park, DDS is a registered healthcare professional specializing in Dentist in Downey, CA. Practice services are available at 8612 FIRESTONE BLVD under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

8612 Firestone Blvd

Downey, CA 902415243

Telephone 5623821528
Associated Practice Facility / Clinic
🏢 Shorouq Sahawneh Facility NPI 1033457635

Specialty Benchmarks & Practice Insights

Comparative analytics for Dentist in Downey, CA

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 14.4 Yrs
Regional Practice Density
73 Specialists

Practicing in Downey, CA (15331 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

CMS Verified: 2022-08-17
Dentist Primary Specialty

NUCC Taxonomy Code: 122300000X

State License CA 107810

A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist.

Dentist

NUCC Taxonomy Code: 122300000X

State License MI 2901022211

A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

2 Associated Practitioners
NPI 1952750861

Doctor of Dental Surgery

Claudia Reyes

Dental Assistant

NPI 1962978494

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

21 Historical Events
📍
Updated Practice Location August 19, 2022

Registered at 8612 FIRESTONE BLVD, DOWNEY, CA 902415243 (Tel: 5623821528)

📍
Updated Business Mailing Address August 19, 2022

Registered at 8612 FIRESTONE BLVD, DOWNEY, CA 902415243 (Tel: 5623821528)

📍
Updated Practice Location May 23, 2020

Registered at 23895 NOVI RD STE 500, NOVI, MI 483750202 (Tel: 2483742273)

📍
Updated Business Mailing Address May 23, 2020

Registered at 23895 NOVI RD STE 500, NOVI, MI 483750202 (Tel: 2483742273)

📍
Updated Business Mailing Address April 20, 2020

Registered at 1250 BYRON RD, HOWELL, MI 488431007 (Tel: 5175463330)

📍
Updated Practice Location April 09, 2020

Registered at 1250 BYRON RD, HOWELL, MI 488431007 (Tel: 5175463330)

📍
Updated Practice Location February 19, 2020

Registered at 20720 PLYMOUTH RD, DETROIT, MI 482281275 (Tel: 3133421997)

📍
Updated Business Mailing Address February 19, 2020

Registered at 20720 PLYMOUTH RD, DETROIT, MI 482281275 (Tel: 3133421997)

📍
Updated Practice Location October 17, 2018

Registered at 132 COLE RD, MONROE, MI 481624104 (Tel: 7342427120)

📍
Updated Business Mailing Address October 17, 2018

Registered at 132 COLE RD, MONROE, MI 481624104 (Tel: 7342427120)

NPI Profile Active May 23, 2017

NPI status registered as active in NPPES database

📍
Updated Practice Location May 23, 2017

Registered at 2360 E STADIUM BLVD STE 14, ANN ARBOR, MI 481044887 (Tel: 7346770793)

📍
Updated Business Mailing Address May 23, 2017

Registered at 2360 E STADIUM BLVD STE 14, ANN ARBOR, MI 481044887 (Tel: (734) 677-0793)

👤
Provider Name / Credentials Updated May 23, 2017

Recorded as JUN SUP PARK, DDS

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) May 23, 2017

Dentist (License #2901022211 in MI)

NPI Profile Active April 27, 2017

NPI status registered as active in NPPES database

📍
Updated Practice Location April 27, 2017

Registered at 2360 E STADIUM BLVD, ANN ARBOR, MI 481044887 (Tel: 7346770793)

📍
Updated Business Mailing Address April 27, 2017

Registered at 2360 E STADIUM BLVD, ANN ARBOR, MI 481044887 (Tel: 7346770793)

👤
Provider Name / Credentials Updated April 27, 2017

Recorded as JUN SUP PARK

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) April 27, 2017

Student in an Organized Health Care Education/Training Program

🟢
Initial NPI Registration & Enumeration April 27, 2017

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1669907663
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: April 27, 2017
Last Update: August 19, 2022
Sole Proprietor: No

Mailing Address

8612 Firestone Blvd

Downey, CA 902415243

Phone: 5623821528

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.