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DR. JAE HOUNG PARK DMD
NPI 1336984723
Dentist - General Practice in Las Vegas, NV

Active since June 27, 2024PECOS Enrolled
8380 W CHEYENNE AVE STE 102, LAS VEGAS, NV 89129(360) 536-7522 Get Directions Write a Review

NPPES record last updated: November 26, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Dr. Jae Houng Park Dmd NPPES

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

DR. JAE HOUNG PARK DMD (NPI 1336984723) is an individual general practice provider in Las Vegas, Nevada, licensed in Nevada (8083) and active in the NPI registry since June 2024. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1336984723
Entity TypeIndividualMale
Primary Taxonomy1223G0001X
Provider Legal NameDR. JAE HOUNG PARKCredential: DMD
Location Address8380 W CHEYENNE AVE STE 102Las Vegas, NV 89129-2175
Mailing Address322 Robledo StLas Vegas, NV 89138-6400 · (781) 325-5785
Phone(360) 536-7522
Sole ProprietorNo
Enumeration DateJune 27, 2024
Last NPPES UpdateNovember 26, 2024
NPPES CertifiedNovember 26, 2024
✔ NPI 1336984723 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · General PracticeDental Providers
Taxonomy Code1223G0001X
License✔ Licensed in NV · 8083
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.
8380 W CHEYENNE AVE STE 102, Las Vegas, NV 89129
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arizona Complete Health, Anthem Blue Cross and Blue Shield, BEST Life 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)

Dr. Jae Houng 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 89129 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
$88.51 typical visit price
range $57.07 – $173.24
Typical copayment $22.12 (range $14.26 – $43.31)
Most-billed visit code 99203
Established Patient
$71.14 typical visit price
range $18.27 – $140.96
Typical copayment $17.78 (range $4.56 – $35.24)
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 5

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

MATTHEW L KOSCINSKI DDS
Dentist (General Practice)
8380 W CHEYENNE AVE STE 102
LAS VEGAS, NV 89129
Clark County (702) 388-8989
HUNTER TAN DMD
Student in an Organized Health Care Education/Training Program
8380 W CHEYENNE AVE STE 102
LAS VEGAS, NV 89129
Clark County (714) 769-0613
NOREEN RAFIK MAVRAKIS
Dentist (General Practice)
8380 W CHEYENNE AVE STE 102
LAS VEGAS, NV 89129
Clark County (360) 536-7522
PRABHANDH REDDY GOLLAPALLE
Student in an Organized Health Care Education/Training Program
8380 W CHEYENNE AVE STE 102
LAS VEGAS, NV 89129
Clark County (360) 536-7522
DR. JUN YUAN XIAO
Dentist
8380 W CHEYENNE AVE STE 102
LAS VEGAS, NV 89129
Clark County (702) 291-2031

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 Houng Park's NPI number?

The NPI number for Jae Houng Park is 1336984723. It was assigned to this individual provider in the NPPES registry on June 27, 2024.

Where is Jae Houng Park located?

Jae Houng Park practices at 8380 W Cheyenne Ave Ste 102, Las Vegas, NV 89129. The listed phone number is (360) 536-7522.

What is Jae Houng Park's specialty?

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

Is Jae Houng Park enrolled in Medicare?

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

What insurance does Jae Houng Park accept?

Health plans from Ambetter from Arizona Complete Health, Anthem Blue Cross and Blue Shield, BEST Life, Blue Cross and Blue Shield of Montana and Blue Cross and Blue Shield of Oklahoma and 7 other insurers list Jae Houng 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 Houng Park was last updated on November 26, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 20 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.