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JOHN JUWON PARK DMD
NPI 1083866982
Dentist - Pediatric Dentistry in Albany, NY

Active since October 22, 2008PECOS Enrolled
4 EXECUTIVE PARK DR, ALBANY, NY 12203(347) 408-8673 Get Directions Write a Review

NPPES record last updated: May 17, 2018. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About John Juwon Park Dmd NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JOHN JUWON PARK DMD (NPI 1083866982) is an individual pediatric dentistry provider in Albany, New York, licensed in New York (056491) and active in the NPI registry since October 2008. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1083866982
Entity TypeIndividualMale
Primary Taxonomy1223P0221X
Provider Legal NameJOHN JUWON PARKCredential: DMD
Location Address4 EXECUTIVE PARK DRAlbany, NY 12203
Mailing Address255 Patroon Creek Blvd Apt 1405Albany, NY 12206-5019 · (347) 408-8673
Phone(347) 408-8673
Sole ProprietorNo
Enumeration DateOctober 22, 2008
Last NPPES UpdateMay 17, 2018
✔ NPI 1083866982 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · Pediatric DentistryDental Providers
Taxonomy Code1223P0221X
License✔ Licensed in NY · 056491
Definition
An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs.
4 EXECUTIVE PARK DR, Albany, NY 12203
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma, Blue Cross and Blue Shield of Texas and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

John Juwon Park Dmd is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 12203 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$84.93 typical visit price
range $54.87 – $166.88
Typical copayment $21.23 (range $13.71 – $41.72)
Most-billed visit code 99203
Established Patient
$68.57 typical visit price
range $17.54 – $136.14
Typical copayment $17.14 (range $4.38 – $34.03)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DEBBIE ANN KENNEDY V M.D.
Specialist
4 EXECUTIVE PARK DR
ALBANY, NY 12203
Albany County (518) 438-1434
JOSHUA A KING M.D.
Specialist
4 EXECUTIVE PARK DR
ALBANY, NY 12203
Albany County (518) 438-1434
SPORTS THERAPY ALBANY P.T, P.C.
Physical Therapist
4 EXECUTIVE PARK DR
ALBANY, NY 12203
Albany County (518) 489-2449
MR. THOMAS F. FASHOUER A.T.C.
Specialist/Technologist (Athletic Trainer)
4 EXECUTIVE PARK DR, ALBANY PHYSICAL THERAPY
ALBANY, NY 12203
Albany County (518) 489-2449
MS. PHRANCES BLAY HINCH M.S. NPP
Nurse Practitioner (Psychiatric/Mental Health)
4 EXECUTIVE PARK DR
ALBANY, NY 12203
Albany County (518) 438-9722
ELIZABETH DEMIS LCSW-R
Social Worker (Clinical)
4 EXECUTIVE PARK DR
ALBANY, NY 12203
Albany County (518) 438-9722
CAPITAL REGION UROLOGICAL SURGEONS
Specialist
4 EXECUTIVE PARK DR
ALBANY, NY 12203
Albany County (518) 489-7494
MS. SUSAN C MAILLE LCSWR
Social Worker (Clinical)
4 EXECUTIVE PARK DR, SUITE 201
ALBANY, NY 12203
Albany County (518) 728-8910

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is John Park's NPI number?

The NPI number for John Park is 1083866982. It was assigned to this individual provider in the NPPES registry on October 22, 2008.

Where is John Park located?

John Park practices at 4 Executive Park Dr, Albany, NY 12203. The listed phone number is (347) 408-8673.

What is John Park's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Pediatric Dentistry, with taxonomy code 1223P0221X.

Is John Park enrolled in Medicare?

Yes. John Park is registered in the Medicare PECOS enrollment system.

What insurance does John Park accept?

Health plans from Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma, Blue Cross and Blue Shield of Texas, Humana and Renaissance Dental list John Park as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for John Park was last updated on May 17, 2018. NPI Profile syncs with the weekly NPPES data releases published by CMS.