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JAEWOO PARK DDS
NPI 1184105330
Dentist - General Practice in Glen Burnie, MD

Active since August 26, 2018
100 CRAIN HWY S, GLEN BURNIE, MD 21061(071) 490-0116 Get Directions Write a Review

NPPES record last updated: July 28, 2021. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Jul 28, 2021, Aug 26, 2018 (2 updates tracked since 2018).

About Jaewoo Park Dds NPPES

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

JAEWOO PARK DDS (NPI 1184105330) is an individual general practice provider in Glen Burnie, Maryland, licensed in Maryland (17153) and active in the NPI registry since August 2018. He maintains a secondary practice location in York.

NPPES Registry Identity

NPI1184105330
Entity TypeIndividualMale
Primary Taxonomy1223G0001X
Provider Legal NameJAEWOO PARKCredential: DDS
Location Address100 CRAIN HWY SGlen Burnie, MD 21061-3528
Mailing Address810 Concorde Cir Unit 34419Linthicum Heights, MD 21090-2965 · (714) 900-1168
Phone(071) 490-0116
Sole ProprietorYes
Enumeration DateAugust 26, 2018
Last NPPES UpdateJuly 28, 20212 updates tracked since enumeration
NPPES CertifiedJuly 28, 2021
✔ NPI 1184105330 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · General PracticeDental Providers
Taxonomy Code1223G0001X
Licenses✔ Licensed in MD · 17153✔ Licensed in PA · DS041945
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.
100 CRAIN HWY S, Glen Burnie, MD 21061
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Secondary Practice Location 1

Location 1351 Loucks Rd Ste E4York, PA 17404-1740 · Phone (717) 848-3600

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 ›

Other Providers at the Same Location NPPES 2

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

SMILE UP DENTAL CENTER
Dentist (General Practice)
100 CRAIN HWY S
GLEN BURNIE, MD 21061
Anne Arundel County (410) 969-9300
DR. NADER AFGAN D.D.S.
Dentist
100 CRAIN HWY S
GLEN BURNIE, MD 21061
Anne Arundel County (410) 969-9300

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 Jaewoo Park's NPI number?

The NPI number for Jaewoo Park is 1184105330. It was assigned to this individual provider in the NPPES registry on August 26, 2018.

Where is Jaewoo Park located?

Jaewoo Park practices at 100 Crain Hwy S, Glen Burnie, MD 21061. The listed phone number is (071) 490-0116.

What is Jaewoo Park's specialty?

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

What insurance does Jaewoo 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 5 other insurers list Jaewoo 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 Jaewoo Park was last updated on July 28, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.