Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1558718437 Individual Practitioner Male Practitioner

Dr. John Joontae Park , DDS

Dentist - General Practice • Portland, OR

Professional Overview & Biography Verified Profile Summary

Dr. John Park, DDS is a registered healthcare professional specializing in Dentist - General Practice in Portland, OR. Practice services are available at 2100 NE BROADWAY ST STE 205 under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

2100 Ne Broadway St Ste 205

Portland, OR 972321500

Telephone 5032842893
Fax 5032872016
Associated Practice Facility / Clinic
🏢 John J Park Llc Facility NPI 1992584288

Specialty Benchmarks & Practice Insights

Comparative analytics for Dentist - General Practice in Portland, OR

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 9.0 Yrs
State Avg: 13.7 Yrs
Regional Practice Density
448 Specialists

Practicing in Portland, OR (1994 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: 2024-10-21
Dentist - General Practice Primary Specialty

NUCC Taxonomy Code: 1223G0001X

State License OR D10627

A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.

Student in an Organized Health Care Education/Training Program

NUCC Taxonomy Code: 390200000X

An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

Practice Associates & Co-Workers

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

1 Associated Practitioners
Dr. Jeffery Egger , DMD, PC

Dentist - General Practice

NPI 1427190834

Doctor of Dental Medicine, PC

Career & Practice History Timeline

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

11 Historical Events
📍
Updated Practice Location October 21, 2024

Registered at 2100 NE BROADWAY ST STE 205, PORTLAND, OR 972321500 (Tel: 5032842893)

📍
Updated Business Mailing Address October 21, 2024

Registered at 2100 NE BROADWAY ST STE 205, PORTLAND, OR 972321500 (Tel: 5032842893)

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) October 21, 2024

Student in an Organized Health Care Education/Training Program

📍
Updated Practice Location January 19, 2021

Registered at 9997 SE 82ND AVE, HAPPY VALLEY, OR 970862301 (Tel: 5032249009)

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) January 19, 2021

Dentist (License #D10627 in OR)

NPI Profile Active May 19, 2016

NPI status registered as active in NPPES database

📍
Updated Practice Location May 19, 2016

Registered at 8829 HAWTHORNE CT, ELLICOTT CITY, MD 210433317 (Tel: 4104650602)

📍
Updated Business Mailing Address May 19, 2016

Registered at 8829 HAWTHORNE CT, ELLICOTT CITY, MD 210433317 (Tel: 4104650602)

👤
Provider Name / Credentials Updated May 19, 2016

Recorded as JOHN PARK, D.D.S.

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) May 19, 2016

Student in an Organized Health Care Education/Training Program

🟢
Initial NPI Registration & Enumeration May 19, 2016

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: 1558718437
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: May 19, 2016
Last Update: October 21, 2024
Sole Proprietor: No

Mailing Address

2100 Ne Broadway St Ste 205

Portland, OR 972321500

Phone: 5032842893

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.