Jae Park, DMD
NPI 1336649573 · Pediatric Dentistry · Bronx, NY
Enrolled with Medicare as Order and Referring Only - Dentist · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Jae Park, DMD is a Pediatric Dentistry provider in Bronx, NY (NPI 1336649573).
Provider details
- NPI number
- 1336649573
- Entity type
- Individual
- Primary specialty
- Pediatric DentistryDental Providers
- Credential
- DMD
- Sex
- Male
- Sole proprietor
- Yes
- License
- 061100 (NY)
Specialties & taxonomies
Dental Providers
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
8 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Registry dates
- Enumerated
- 2018-02-14
- Last updated
- 2023-09-05
- Certified
- 2023-09-05
Frequently asked questions
- What is Jae Park's NPI number?
- Jae Park's National Provider Identifier (NPI) is 1336649573, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What is Jae Park's specialty?
- Jae Park is listed in the NPPES registry with a primary specialty of Pediatric Dentistry (Dental Providers).
- Where is Jae Park located?
- Jae Park's practice location on file with NPPES is 1400 Pelham Pkwy S, Bronx, NY 10461-1138.
- What is Jae Park's phone number?
- The practice phone number listed in the NPPES registry for Jae Park is (214) 228-7043.
- Does Jae Park accept Medicare?
- Jae Park is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Is Jae Park's NPI active?
- Yes — Jae Park's NPI (1336649573) is active in the NPPES registry as of the last update on 2023-09-05.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.