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DONG JIN PARK
NPI 1174888622
Dentist - General Practice in Meriden, CT

Active since July 11, 2012PECOS Enrolled
490 S BROAD ST, MERIDEN, CT 06450(203) 237-1000 Get Directions Write a Review

NPPES record last updated: September 26, 2013. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Dong Jin Park NPPES

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

DONG JIN PARK (NPI 1174888622) is an individual general practice provider in Meriden, Connecticut, licensed in Connecticut (010794) and active in the NPI registry since July 2012. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1174888622
Entity TypeIndividualMale
Primary Taxonomy1223G0001X
Provider Legal NameDONG JIN PARK
Location Address490 S BROAD STMeriden, CT 06450
Mailing Address490 S Broad StMeriden, CT 06450 · (203) 237-1000
Phone(203) 237-1000
Sole ProprietorNo
Enumeration DateJuly 11, 2012
Last NPPES UpdateSeptember 26, 2013
✔ NPI 1174888622 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyDentist · General PracticeDental Providers
Taxonomy Code1223G0001X
License✔ Licensed in CT · 010794
Definition
A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.
Also ListedDentistTaxonomy 122300000X · License 010794 (CT)
490 S BROAD ST, Meriden, CT 06450
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, BEST Life, Blue Cross and Blue Shield of Montana 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)

Dong Jin Park 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 06450 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
$93.86 typical visit price
range $60.82 – $183.10
Typical copayment $23.46 (range $15.20 – $45.77)
Most-billed visit code 99203
Established Patient
$75.55 typical visit price
range $19.76 – $149.26
Typical copayment $18.88 (range $4.94 – $37.31)
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

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

ANJALI BANERJEE DMD PLLC
Dentist (General Practice)
490 S BROAD ST, STE 19
MERIDEN, CT 06450
South Central Connecticut Planning Region (203) 237-1000

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 Dong Jin Park's NPI number?

The NPI number for Dong Jin Park is 1174888622. It was assigned to this individual provider in the NPPES registry on July 11, 2012.

Where is Dong Jin Park located?

Dong Jin Park practices at 490 S Broad St, Meriden, CT 06450. The listed phone number is (203) 237-1000.

What is Dong Jin Park's specialty?

The primary specialty registered for this NPI is Dentist, specializing in General Practice, with taxonomy code 1223G0001X.

Is Dong Jin Park enrolled in Medicare?

Yes. Dong Jin Park is registered in the Medicare PECOS enrollment system.

What insurance does Dong Jin Park accept?

Health plans from Anthem Blue Cross and Blue Shield, BEST Life, Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma and Blue Cross and Blue Shield of Texas and 6 other insurers list Dong Jin 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 Dong Jin Park was last updated on September 26, 2013. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.