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SOOH PARK
NPI 1477956175
Dentist - General Practice in Yucaipa, CA

Active since October 08, 2014PECOS Enrolled
34880 YUCAIPA BLVD, YUCAIPA, CA 92399(909) 797-1136 Get Directions Write a Review

NPPES record last updated: January 6, 2022. Verified against the NPPES registry weekly; last sync: August 23, 2026.

About Sooh Park NPPES

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

SOOH PARK (NPI 1477956175) is an individual general practice provider in Yucaipa, California, licensed in California (63849) and active in the NPI registry since October 2014. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1477956175
Entity TypeIndividualFemale
Primary Taxonomy1223G0001X
Provider Legal NameSOOH PARK
Location Address34880 YUCAIPA BLVDYucaipa, CA 92399-4235
Mailing Address34880 Yucaipa BlvdYucaipa, CA 92399-4235
Phone(909) 797-1136
Sole ProprietorNo
Enumeration DateOctober 8, 2014
Last NPPES UpdateJanuary 6, 2022
NPPES CertifiedJanuary 6, 2022
✔ NPI 1477956175 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyDentist · General PracticeDental Providers
Taxonomy Code1223G0001X
License✔ Licensed in CA · 63849
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.
Also ListedDentistTaxonomy 122300000X · License 63849 (CA)
34880 YUCAIPA BLVD, Yucaipa, CA 92399
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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)

Sooh 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 92399 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
$91.88 typical visit price
range $59.60 – $179.42
Typical copayment $22.97 (range $14.90 – $44.85)
Most-billed visit code 99203
Established Patient
$74.08 typical visit price
range $19.37 – $146.42
Typical copayment $18.52 (range $4.84 – $36.60)
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.

DR. NATHANIEL WEN-WEI LENG D.D.S
Dentist (General Practice)
34880 YUCAIPA BLVD
YUCAIPA, CA 92399
San Bernardino County (909) 797-1136
DR. SUDHAKAR R CHOKKA DDS
Dentist (General Practice)
34880 YUCAIPA BLVD
YUCAIPA, CA 92399
San Bernardino County (909) 797-1136
DR. MIRIAM MIKHAEL FIDAL DDS
Dentist (General Practice)
34880 YUCAIPA BLVD
YUCAIPA, CA 92399
San Bernardino County (909) 797-1136
CHOKKA DENTAL CORPORATION
Dentist (Orthodontics and Dentofacial Orthopedics)
34880 YUCAIPA BLVD
YUCAIPA, CA 92399
San Bernardino County (909) 797-1136
DR. KEVIN CHUNG DDS
Dentist (General Practice)
34880 YUCAIPA BLVD
YUCAIPA, CA 92399
San Bernardino County (909) 797-1136

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 Sooh Park's NPI number?

The NPI number for Sooh Park is 1477956175. It was assigned to this individual provider in the NPPES registry on October 8, 2014.

Where is Sooh Park located?

Sooh Park practices at 34880 Yucaipa Blvd, Yucaipa, CA 92399. The listed phone number is (909) 797-1136.

What is Sooh Park's specialty?

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

Is Sooh Park enrolled in Medicare?

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

What insurance does Sooh 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 6 other insurers list Sooh 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 Sooh Park was last updated on January 6, 2022. 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.