Dr. Jake Yong Park , DDS
Dentist • Bellevue, WA
Notice of NPI Deactivation & Inactive Practice Status
According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Dr. Jake Park has officially deactivated this NPI record and ceased active healthcare practice.
Professional Overview & Biography Verified Profile Summary
Dr. Jake Park, DDS was a registered Dentist practicing in Bellevue, WA. Throughout an active medical career spanning 4 years, Dr. Park provided care at the practice location at 12832 SE 40TH LN until profile deactivation on 2012-12-11.
Practice Location & Contact Primary Location
12832 Se 40th Ln
Ste 201
Bellevue, WA 980061241
Specialty Benchmarks & Practice Insights
Comparative analytics for Dentist in Bellevue, WA
Practicing in Bellevue, WA (2853 Statewide)
In-Person Office Visits Only
Under CMS Medicare Fee Schedule vs Standard Submitted Charges
Medical Specialties & State Licenses
NUCC Taxonomy Code: 122300000X
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.
NUCC Taxonomy Code: 122300000X
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.
Career & Practice History Timeline
Chronological log of verified NPI updates, location relocations, credentials, and registry changes
Registered at 12832 SE 40TH LN, STE 201, BELLEVUE, WA 980061241 (Tel: 4256368432)
Registered at 18707 SE NEWPORT WAY, ISSAQUAH, WA 980279087 (Tel: 2067474446)
Recorded as JAKE PARK, DDS
Dentist (License #DE 00011037 in WA)
Record officially reactivated for active practice on January 29, 2013
Record deactivated on December 11, 2012
First registered as active Individual Practitioner in NPPES Database.
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NPI Administrative Meta
Mailing Address
18707 Se Newport Way
Issaquah, WA 980279087
Phone: 2067474446
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