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Active NPI 1043983364 Individual Practitioner Male Practitioner

Dr. Jung Won Park , DDS

Dentist • Tyler, TX

Professional Overview & Biography Verified Profile Summary

Dr. Jung Won Park, DDS is a registered healthcare professional specializing in Dentist in Tyler, TX. Practice services are available at 212 OLD GRANDE BLVD STE B224 under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

212 Old Grande Blvd Ste B224

Tyler, TX 757034277

Telephone 9035090505
Associated Practice Facility / Clinic

Specialty Benchmarks & Practice Insights

Comparative analytics for Dentist in Tyler, TX

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 18.7 Yrs
Regional Practice Density
47 Specialists

Practicing in Tyler, TX (6851 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: 2021-08-02
Dentist Primary Specialty

NUCC Taxonomy Code: 122300000X

State License TX 37630

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

3 Associated Practitioners
Dr. Bruna Kennedy , DDS

Dentist - General Practice

NPI 1174445621

Doctor of Dental Surgery

Janaki Khot

Dentist - Orthodontics and Dentofacial Orthopedics

NPI 1689551665
Steve Lebo , D, DS

Dentist - General Practice

NPI 1902910920

Career & Practice History Timeline

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

6 Historical Events
NPI Profile Active August 02, 2021

NPI status registered as active in NPPES database

📍
Updated Practice Location August 02, 2021

Registered at 212 OLD GRANDE BLVD STE B224, TYLER, TX 757034277 (Tel: 9035090505)

📍
Updated Business Mailing Address August 02, 2021

Registered at 11 S MILL ST STE 200, NEW CASTLE, PA 161013680 (Tel: 2253242493)

👤
Provider Name / Credentials Updated August 02, 2021

Recorded as JUNG WON PARK, DDS

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) August 02, 2021

Dentist (License #37630 in TX)

🟢
Initial NPI Registration & Enumeration August 02, 2021

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: 1043983364
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: August 02, 2021
Last Update: August 02, 2021
Sole Proprietor: No

Mailing Address

11 S Mill St Ste 200

New Castle, PA 161013680

Phone: 2253242493

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.