Geonwoong Park, DDS
NPI 1659109163 · General Practice Dentistry · Rockford, IL
Enrolled with Medicare as Order and Referring Only - Dentist · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Geonwoong Park, DDS is a General Practice Dentistry provider in Rockford, IL (NPI 1659109163).
Provider details
- NPI number
- 1659109163
- Entity type
- Individual
- Primary specialty
- General Practice DentistryDental Providers
- Credential
- DDS
- Sex
- Male
- Sole proprietor
- No
- License
- 019035398 (IL)
Specialties & taxonomies
Dental Providers
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
1 yr 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
- 2024-07-25
- Last updated
- 2025-08-14
- Certified
- 2025-08-14
Frequently asked questions
- What is Geonwoong Park's NPI number?
- Geonwoong Park's National Provider Identifier (NPI) is 1659109163, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What is Geonwoong Park's specialty?
- Geonwoong Park is listed in the NPPES registry with a primary specialty of General Practice Dentistry (Dental Providers).
- Where is Geonwoong Park located?
- Geonwoong Park's practice location on file with NPPES is 1200 W State St, Rockford, IL 61102-2112.
- What is Geonwoong Park's phone number?
- The practice phone number listed in the NPPES registry for Geonwoong Park is (815) 490-1600.
- Does Geonwoong Park accept Medicare?
- Geonwoong Park is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Is Geonwoong Park's NPI active?
- Yes — Geonwoong Park's NPI (1659109163) is active in the NPPES registry as of the last update on 2025-08-14.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.