Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1386110781 Individual Practitioner Male Practitioner

Jae H Park

Dentist • Quantico, VA

Professional Overview & Biography Verified Profile Summary

Jae Park is a registered healthcare professional specializing in Dentist in Quantico, VA. Practice services are available at 3259 CATLIN AVE under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

3259 Catlin Ave

Quantico, VA 221345109

Telephone 7579539000
Associated Practice Facility / Clinic
🏢 Nhc Quantico Facility NPI 1508839903

Specialty Benchmarks & Practice Insights

Comparative analytics for Dentist in Quantico, VA

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 15.7 Yrs
Regional Practice Density
15 Specialists

Practicing in Quantico, VA (2514 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: 2023-02-28
Dentist Primary Specialty

NUCC Taxonomy Code: 122300000X

State License VA 0401416211

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

8 Associated Practitioners
NPI 1184919573

Doctor of Medicine (M.D.)

Mark Bryant , IDC

Military Health Care Provider - Independent Duty Corpsman

NPI 1205954104
Dr. Edward Leitz , MD

Internal Medicine

NPI 1467503722

Doctor of Medicine (M.D.)

Kelly Pilch , PA

Physician Assistant

NPI 1477787349

Physician Assistant

Dr. Jennifer Brown , DNP, FNP-BC

Nurse Practitioner - Primary Care

NPI 1770923484

Doctor of Nursing Practice, Family Nurse Practitioner (Board Certified)

Patrick Donnelly , PA-C

Physician Assistant

NPI 1770994253

Physician Assistant (Certified)

Career & Practice History Timeline

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

8 Historical Events
📍
Updated Practice Location February 28, 2023

Registered at 3259 CATLIN AVE, QUANTICO, VA 221345109 (Tel: 7579539000)

📍
Updated Business Mailing Address February 28, 2023

Registered at 2701 NEABSCO COMMON PL APT 519, WOODBRIDGE, VA 221916717 (Tel: 7032548008)

NPI Profile Active October 23, 2018

NPI status registered as active in NPPES database

📍
Updated Practice Location October 23, 2018

Registered at 1637 ADMIRAL TAUSSIG BLVD, NORFOLK, VA 235112803 (Tel: 7579539000)

📍
Updated Business Mailing Address October 23, 2018

Registered at 145 GRANBY ST APT 505, NORFOLK, VA 235101660 (Tel: 7032548008)

👤
Provider Name / Credentials Updated October 23, 2018

Recorded as JAE PARK

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) October 23, 2018

Dentist (License #0401416211 in VA)

🟢
Initial NPI Registration & Enumeration October 23, 2018

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: 1386110781
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: October 23, 2018
Last Update: February 28, 2023
Sole Proprietor: No

Mailing Address

2701 Neabsco Common Pl Apt 519

Woodbridge, VA 221916717

Phone: 7032548008

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.