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JOHN SIR PARK
NPI 1336395243
Dentist in Broadlands, VA

Active since August 12, 2008PECOS Enrolled
43170 SOUTHERN WALK PLZ STE 116, BROADLANDS, VA 20148(703) 687-4320 Get Directions Write a Review

NPPES record last updated: March 23, 2026. Verified against the NPPES registry weekly; last sync: August 23, 2026.

About John Sir Park NPPES

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

JOHN SIR PARK (NPI 1336395243) is an individual dentist in Broadlands, Virginia, licensed in Virginia (0401414285) and active in the NPI registry since August 2008. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1336395243
Entity TypeIndividualMale
Primary Taxonomy122300000X
Provider Legal NameJOHN SIR PARK
Location Address43170 SOUTHERN WALK PLZ STE 116Broadlands, VA 20148-4464
Mailing Address43170 Southern Walk Plz Ste 116Broadlands, VA 20148-4464 · (703) 687-4320
Phone(703) 687-4320
Sole ProprietorNo
Enumeration DateAugust 12, 2008
Last NPPES UpdateMarch 23, 2026
NPPES CertifiedMarch 23, 2026
✔ NPI 1336395243 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentistDental Providers
Taxonomy Code122300000X
License✔ Licensed in VA · 0401414285
Definition
A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist.
43170 SOUTHERN WALK PLZ STE 116, Broadlands, VA 20148
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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 Alabama 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 Sir 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 20148 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
$86.88 typical visit price
range $56.19 – $170.30
Typical copayment $21.72 (range $14.04 – $42.57)
Most-billed visit code 99203
Established Patient
$70.08 typical visit price
range $18.07 – $138.91
Typical copayment $17.52 (range $4.51 – $34.72)
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 2

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

DR. RENUKA RAO DMD
Dentist
43170 SOUTHERN WALK PLZ STE 116
BROADLANDS, VA 20148
Loudoun County (703) 687-4320
DR. POOYA AFLATOONI DDS
Dentist (General Practice)
43170 SOUTHERN WALK PLZ STE 116
BROADLANDS, VA 20148
Loudoun County (703) 984-9026

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 1336395243. It was assigned to this individual provider in the NPPES registry on August 12, 2008.

Where is John Park located?

John Park practices at 43170 Southern Walk Plz Ste 116, Broadlands, VA 20148. The listed phone number is (703) 687-4320.

What is John Park's specialty?

The primary specialty registered for this NPI is Dentist with taxonomy code 122300000X.

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 Anthem Blue Cross and Blue Shield, BEST Life, Blue Cross and Blue Shield of Alabama, Blue Cross and Blue Shield of Montana and Blue Cross and Blue Shield of Oklahoma and 10 other insurers 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 March 23, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 months 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.