DR. JAE HONG PARK
NPI 1396407011
Otolaryngology in Detroit, MI

Active since October 11, 2021
4100 JOHN R ST, DETROIT, MI 48201(248) 854-4576 Get Directions Write a Review

NPPES record last updated: October 11, 2021. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Dr. Jae Hong Park NPPES

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

DR. JAE HONG PARK (NPI 1396407011) is an individual otolaryngology provider in Detroit, Michigan, licensed in Michigan (4351048809) and active in the NPI registry since October 2021.

NPPES Registry Identity

NPI1396407011
Entity TypeIndividualMale
Primary Taxonomy207Y00000X
Provider Legal NameDR. JAE HONG PARK
Location Address4100 JOHN R STDetroit, MI 48201-2013
Mailing Address1363 Dorothea RdBerkley, MI 48072-2148 · (248) 854-4576
Sole ProprietorNo
Enumeration DateOctober 11, 2021
NPPES CertifiedOctober 11, 2021
NPI 1396407011 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyOtolaryngologyAllopathic & Osteopathic Physicians
Taxonomy Code207Y00000X
License Licensed in MI · 4351048809
Definition
An otolaryngologist-head and neck surgeon provides comprehensive medical and surgical care for patients with diseases and disorders that affect the ears, nose, throat, the respiratory and upper alimentary systems and related structures of the head and neck. An otolaryngologist diagnoses and provides medical and/or surgical therapy or prevention of diseases, allergies, neoplasms, deformities, disorders and/or injuries of the ears, nose, sinuses, throat, respiratory and upper alimentary systems, face, jaws and the other head and neck systems. Head and neck oncology, facial plastic and reconstructive surgery and the treatment of disorders of hearing and voice are fundamental areas of expertise.
4100 JOHN R ST, Detroit, MI 48201

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.

Pharmacy (Community/Retail Pharmacy)
4100 JOHN R ST, SUITE HP00RX
DETROIT, MI 48201
General Acute Care Hospital
4100 JOHN R ST
DETROIT, MI 48201
Internal Medicine (Medical Oncology)
4100 JOHN R ST
DETROIT, MI 48201
Nurse Practitioner
4100 JOHN R ST
DETROIT, MI 48201
Speech-Language Pathologist
4100 JOHN R ST
DETROIT, MI 48201
Nurse Practitioner (Acute Care)
4100 JOHN R ST
DETROIT, MI 48201
Pharmacist
4100 JOHN R ST
DETROIT, MI 48201
Pharmacist (Oncology)
4100 JOHN R ST
DETROIT, MI 48201

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 1396407011. It was assigned to this individual provider in the NPPES registry on October 11, 2021.

Where is Jae Park located?

Jae Park practices at 4100 John R St, Detroit, MI 48201. The listed phone number is (248) 854-4576.

What is Jae Park's specialty?

The primary specialty registered for this NPI is Otolaryngology with taxonomy code 207Y00000X.

When was this NPI record last updated?

The NPPES record for Jae Park was last updated on October 11, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.