Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
DR. JAKE YONG PARK, DDS
Deactivated Sole ProprietorDR. JAKE YONG PARK, DDS is a Dentist healthcare provider located in BELLEVUE, Washington. NPI 1427203868 is deactivated in the NPPES registry. Verify at CMS.
Dentist · BELLEVUE, WA
This NPI has been deactivated.
The record was deactivated on December 11, 2012.
Deactivated NPIs are no longer valid for billing or credentialing. The provider may have retired, changed practice status, or had their NPI administratively deactivated.
Verify current licensure status with the NPPES NPI Registry or the relevant state medical board before relying on this record.
Registration Details
- NPI Number
- 1427203868
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Nov 26, 2008 (4.041095890411 yrs)
- Last Updated
- Aug 4, 2014
- Deactivated
- Dec 11, 2012
- Licenses
-
56979 (CA)DE 00011037 (WA)
- Sole Proprietor
- Yes
Practice Information
- Address
-
12832 SE 40TH LNSTE 201BELLEVUE, WA, 980061241Browse WA providers · Browse ZIP 98006
- Phone
- 4256368432
- Primary Specialty
-
Dentist
122300000X
- Additional Specialty
- Dentist
Other Dentist Providers in BELLEVUE, WA
| Name | Credential | NPI |
|---|---|---|
| MR. BRIAN D. BROOKS | D.D.S. | 1205833126 |
| DR. ELLEN E REH | D.D.S. | 1861475873 |
| STANLEY KAZUO NISHIMURA | DDS | 1609850437 |
| DR. ROBERT JOHN UHDE | DDS | 1831177989 |
| DR. PUNITPAL SINGH AULAKH | DDS | 1699749994 |
| DR. KENYU TAKAMOTO | DDS MSD | 1619928819 |
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.