Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
JAEWOO PARK, DDS
Active Sole ProprietorJAEWOO PARK, DDS is a General Dentistry healthcare provider located in GLEN BURNIE, Maryland. NPI 1184105330 is currently active in the NPPES registry. Verify at CMS.
General Dentistry · GLEN BURNIE, MD
Registration Details
- NPI Number
- 1184105330
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Aug 26, 2018 (7.9804870337439 yrs)
- Last Updated
- Jul 28, 2021
- Licenses
-
DS041945 (PA)17153 (MD)
- Sole Proprietor
- Yes
Practice Information
- Address
-
100 CRAIN HWY SGLEN BURNIE, MD, 210613528Browse MD providers · Browse ZIP 21061
- Phone
- 0714900116
- Primary Specialty
-
General Dentistry
1223G0001X
- Additional Specialty
- General Dentistry
Other General Dentistry Providers in GLEN BURNIE, MD
| Name | Credential | NPI |
|---|---|---|
| DR. ROSS I HEISMAN | DDS | 1679567283 |
| DR. MARK S. GURMAN | DMD | 1295748796 |
| DR. LISA YVETTE KING-BAKER | DDS | 1407967144 |
| WILLIAM RICHARD JOHNSON | DDS | 1164507521 |
| TAM NGUYEN | D.M.D. | 1811076250 |
| DR. GRACE A ALTMANN | DMD | 1407935711 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.