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DR. YONG JUN DAVID PARK DDS MD
NPI 1215114301
Dentist - Oral and Maxillofacial Surgery in Garden Grove, CA

Active since January 30, 2008Opted out of Medicare · through Jan 26, 2027
12777 VALLEY VIEW ST STE 121, GARDEN GROVE, CA 92845(714) 897-3543(714) 897-0505 Get Directions Write a Review

NPPES record last updated: September 25, 2019. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Sep 25, 2019, Sep 20, 2019, Sep 9, 2019 (3 updates tracked since 2019).

About Dr. Yong Jun David Park Dds Md NPPES

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

DR. YONG JUN DAVID PARK DDS MD (NPI 1215114301) is an individual oral and maxillofacial surgery provider in Garden Grove, California, licensed in California (52768) and active in the NPI registry since January 2008. He has opted out of Medicare through January 26, 2027.

NPPES Registry Identity

NPI1215114301
Entity TypeIndividualMale
Primary Taxonomy1223S0112X
Provider Legal NameDR. YONG JUN DAVID PARKCredential: DDS MD
Location Address12777 VALLEY VIEW ST STE 121Garden Grove, CA 92845-2521
Mailing Address12777 Valleyview St. #121Garden Grove, CA 92845-8318 · (714) 897-3543 · Fax (714) 897-0505
Phone(714) 897-3543
Fax(714) 897-0505
Sole ProprietorYes
Enumeration DateJanuary 30, 2008
Last NPPES UpdateSeptember 25, 20193 updates tracked since enumeration
✔ NPI 1215114301 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · Oral and Maxillofacial SurgeryDental Providers
Taxonomy Code1223S0112X
License✔ Licensed in CA · 52768
Definition
An oral and maxillofacial surgery dentist specialized in the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region.
12777 VALLEY VIEW ST STE 121, Garden Grove, CA 92845
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Other Names 1

Other Name (5)Dr. David Yong Park Dds Md

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

ⓘ

Opted out of Medicare

Dr. Yong Jun David Park Dds Md has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from January 26, 2023 through January 26, 2027.

Opt-Out Effective DateJanuary 26, 2023
Opt-Out In Effect ThroughJanuary 26, 2027Opt-out affidavits renew automatically every two years unless cancelled

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.

MADELINE HOOPS
Behavior Technician
12777 VALLEY VIEW ST STE 121
GARDEN GROVE, CA 92845
Orange County (714) 392-2112
MIKHAYLA DESIREE WILKINS
Behavior Technician
12777 VALLEY VIEW ST STE 121
GARDEN GROVE, CA 92845
Orange County (714) 337-6484
HARMONY PANAMENO
Behavior Technician
12777 VALLEY VIEW ST STE 121
GARDEN GROVE, CA 92845
Orange County (714) 337-6484
HRISTINA KIRILOVA EVTIMOVA
Behavior Technician
12777 VALLEY VIEW ST STE 121
GARDEN GROVE, CA 92845
Orange County (714) 337-6484
LEILA PAULINE WALLACE
Behavior Technician
12777 VALLEY VIEW ST STE 121
GARDEN GROVE, CA 92845
Orange County (714) 337-6484
QUINN MICHAEL MUNOZ
Behavior Technician
12777 VALLEY VIEW ST STE 121
GARDEN GROVE, CA 92845
Orange County (714) 337-6484
REBECKA VICTORIA SUSA MARZAN
Behavior Technician
12777 VALLEY VIEW ST STE 121
GARDEN GROVE, CA 92845
Orange County (714) 337-6484
SAMANTHA ALEXANDRA MOHAMMED
Behavior Technician
12777 VALLEY VIEW ST STE 121
GARDEN GROVE, CA 92845
Orange County (714) 337-6484

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 Yong Jun Park's NPI number?

The NPI number for Yong Jun Park is 1215114301. It was assigned to this individual provider in the NPPES registry on January 30, 2008. The provider is also known as Dr. David Yong Park Dds MD.

Where is Yong Jun Park located?

Yong Jun Park practices at 12777 Valley View St Ste 121, Garden Grove, CA 92845. The listed phone number is (714) 897-3543.

What is Yong Jun Park's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Oral and Maxillofacial Surgery, with taxonomy code 1223S0112X.

Is Yong Jun Park enrolled in Medicare?

No. Yong Jun Park has opted out of Medicare through January 26, 2027. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out.

What insurance does Yong Jun 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 and Humana list Yong Jun 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 Yong Jun Park was last updated on September 25, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.