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JAE HONG PARK DMD
NPI 1336649573
Dentist - Pediatric Dentistry in Bronx, NY

Active since February 14, 2018PECOS Enrolled
1400 PELHAM PKWY S, BRONX, NY 10461(214) 228-7043 Get Directions Write a Review

NPPES record last updated: September 5, 2023. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Sep 5, 2023, Feb 24, 2021, Sep 3, 2020 and 1 more (4 updates tracked since 2018).

About Jae Hong Park Dmd NPPES

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

JAE HONG PARK DMD (NPI 1336649573) is an individual pediatric dentistry provider in Bronx, New York, licensed in New York (061100) and active in the NPI registry since February 2018. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1336649573
Entity TypeIndividualMale
Primary Taxonomy1223P0221X
Provider Legal NameJAE HONG PARKCredential: DMD
Location Address1400 PELHAM PKWY SBronx, NY 10461-1138
Mailing Address1400 Pelham Pkwy S Bldg 1Bronx, NY 10461-1119 · (347) 509-4084
Phone(214) 228-7043
Sole ProprietorYes
Enumeration DateFebruary 14, 2018
Last NPPES UpdateSeptember 5, 20234 updates tracked since enumeration
NPPES CertifiedSeptember 5, 2023
✔ NPI 1336649573 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 · 061100
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.
1400 PELHAM PKWY S, Bronx, NY 10461
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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)

Jae Hong 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 10461 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
$105.06 typical visit price
range $67.40 – $203.53
Typical copayment $26.26 (range $16.85 – $50.88)
Most-billed visit code 99203
Established Patient
$83.44 typical visit price
range $21.66 – $164.45
Typical copayment $20.86 (range $5.41 – $41.11)
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.

CAROLYN COLE
Student in an Organized Health Care Education/Training Program
1400 PELHAM PKWY S
BRONX, NY 10461
Bronx County (718) 918-5820
RYAN JOHNY PHARM. D
Pharmacist
1400 PELHAM PKWY S
BRONX, NY 10461
Bronx County (718) 918-4557
DR. SARAH G JAMISON MD
Emergency Medicine
1400 PELHAM PKWY S, BUILDING 6, SUITE B125
BRONX, NY 10461
Bronx County (718) 918-5820
SWETHA PEDAVALLY M.D
Psychiatry & Neurology (Clinical Neurophysiology)
1400 PELHAM PKWY S, BUILDING #1, 3N1
BRONX, NY 10461
Bronx County (718) 918-7460
MS. ODESSA FYNN CM
Midwife
1400 PELHAM PKWY S, BS. 33
BRONX, NY 10461
Bronx County (718) 918-3060
DR. PATRICK SPENCER EIBEN M.D.
Emergency Medicine
1400 PELHAM PKWY S, BUILDING 6//SUITE B125
BRONX, NY 10461
Bronx County (718) 918-5820
DR. ADAM JOSEPH GERSHON MD
Student in an Organized Health Care Education/Training Program
1400 PELHAM PKWY S
BRONX, NY 10461
Bronx County (718) 918-5000
EDIRICARDO RODRIGUEZ ORTIZ MD
Anesthesiology
1400 PELHAM PKWY S
BRONX, NY 10461
Bronx County (718) 918-5000

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 Jae Park's NPI number?

The NPI number for Jae Park is 1336649573. It was assigned to this individual provider in the NPPES registry on February 14, 2018.

Where is Jae Park located?

Jae Park practices at 1400 Pelham Pkwy S, Bronx, NY 10461. The listed phone number is (214) 228-7043.

What is Jae Park's specialty?

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

Is Jae Park enrolled in Medicare?

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

What insurance does Jae 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 Jae 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 Jae Park was last updated on September 5, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.