1. Home
  2. Directory
  3. Maryland
  4. Oxon Hill
  5. Dentist
  6. NPI Profile

SUNGBUM PARK DDS
NPI 1366692147
Dentist - General Practice in Oxon Hill, MD

Active since September 29, 2008PECOS Enrolled
6196 OXON HILL RD STE 540, OXON HILL, MD 20745(301) 686-1665(301) 686-1779 Get Directions Write a Review

NPPES record last updated: September 30, 2024. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Sep 30, 2024, Feb 16, 2023 (2 updates tracked since 2023).

About Sungbum Park Dds NPPES

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

SUNGBUM PARK DDS (NPI 1366692147) is an individual general practice provider in Oxon Hill, Maryland, licensed in Maryland (16038) and active in the NPI registry since September 2008. He is enrolled in Medicare PECOS and maintains a secondary practice location in Brandywine.

NPPES Registry Identity

NPI1366692147
Entity TypeIndividualMale
Primary Taxonomy1223G0001X
Provider Legal NameSUNGBUM PARKCredential: DDS
Location Address6196 OXON HILL RD STE 540Oxon Hill, MD 20745-3112
Mailing Address6196 Oxon Hill Rd Ste 540Oxon Hill, MD 20745-3112 · (301) 686-1665
Phone(301) 686-1665
Fax(301) 686-1779
Sole ProprietorNo
Enumeration DateSeptember 29, 2008
Last NPPES UpdateSeptember 30, 20242 updates tracked since enumeration
NPPES CertifiedSeptember 30, 2024
✔ NPI 1366692147 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · General PracticeDental Providers
Taxonomy Code1223G0001X
License✔ Licensed in MD · 16038
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.
6196 OXON HILL RD STE 540, Oxon Hill, MD 20745
Open in Google Maps ↗

Secondary Practice Location 1

Location 17450 Albert Rd Fl 1Brandywine, MD 20613-3035 · Phone (301) 836-9645 · Fax (301) 579-9034

Other Identifiers 1

Medicaid415611100MD

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 ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Sungbum Park Dds 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 20745 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
$100.31 typical visit price
range $65.18 – $194.86
Typical copayment $25.07 (range $16.29 – $48.71)
Most-billed visit code 99203
Established Patient
$80.66 typical visit price
range $21.40 – $158.88
Typical copayment $20.16 (range $5.35 – $39.72)
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 6

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

FREDA ANSAH-LARBI DNP
Nurse Practitioner (Family)
6196 OXON HILL RD STE 540
OXON HILL, MD 20745
Prince George's County (301) 686-1665
MS. ALICIA CHERIE BELTON DDS
Dentist
6196 OXON HILL RD STE 540
OXON HILL, MD 20745
Prince George's County (301) 888-2233
GREATER BADEN MEDICAL SERVICE INCORPORATED
Clinic/Center (Federally Qualified Health Center (FQHC))
6196 OXON HILL RD STE 540
OXON HILL, MD 20745
Prince George's County (301) 686-1665
CHINTAN P PATEL MD
Pediatrics
6196 OXON HILL RD STE 540
OXON HILL, MD 20745
Prince George's County (301) 686-1665
DR. CARMEN L RUTH CHRISTOPHER D.D.S
Dentist
6196 OXON HILL RD STE 540
OXON HILL, MD 20745
Prince George's County (301) 888-2233
GREATER BADEN MEDICAL SERVICE INCORPORATED
Clinic/Center (Dental)
6196 OXON HILL RD STE 540
OXON HILL, MD 20745
Prince George's County (301) 686-1665

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 Sungbum Park's NPI number?

The NPI number for Sungbum Park is 1366692147. It was assigned to this individual provider in the NPPES registry on September 29, 2008.

Where is Sungbum Park located?

Sungbum Park practices at 6196 Oxon Hill Rd Ste 540, Oxon Hill, MD 20745. The listed phone number is (301) 686-1665.

What is Sungbum Park's specialty?

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

Is Sungbum Park enrolled in Medicare?

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

What insurance does Sungbum 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 6 other insurers list Sungbum 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 Sungbum Park was last updated on September 30, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 22 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.