EUN JIN PARK
NPI 1689044679
Dentist - General Practice in Manteca, CA

Q: What is Eun Jin Park's NPI number?

The NPI number for Eun Jin Park is 1689044679. It was assigned to this individual provider in the NPPES registry on October 2, 2015.

Q: What is Eun Jin Park's specialty?

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

Q: When was this NPI record last updated?

The NPPES record for Eun Jin Park was last updated on October 2, 2015. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 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.

Active since October 02, 2015PECOS Enrolled

2288 DANIELS ST, MANTECA, CA 95337(209) 456-5610 Get Directions Write a Review

NPPES record last updated: October 2, 2015. Verified against the NPPES registry weekly; last sync: August 09, 2026.

On this page

About Eun Jin Park NPPES

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

EUN JIN PARK (NPI 1689044679) is an individual general practice provider in Manteca, California, licensed in California (65154) and active in the NPI registry since October 2015. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1689044679

Entity TypeIndividualFemale

Primary Taxonomy1223G0001X

Provider Legal NameEUN JIN PARK

Location Address2288 DANIELS STManteca, CA 95337-6706

Mailing Address801 Atherton Dr Apt 158Manteca, CA 95337-7961

Phone(209) 456-5610

Sole ProprietorNo

Enumeration DateOctober 2, 2015

✔ NPI 1689044679 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · General PracticeDental Providers

Taxonomy Code1223G0001X

License✔ Licensed in CA · 65154

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.

2288 DANIELS ST, Manteca, CA 95337

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include BEST Life, Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma 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)

Eun Jin 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 95337 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

$90.32 typical visit price

range $58.87 – $176.60

Typical copayment $22.58 (range $14.71 – $44.15)

Most-billed visit code 99203

Established Patient

$73.16 typical visit price

range $19.28 – $144.60

Typical copayment $18.29 (range $4.82 – $36.15)

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.

AKSHDEEP KAUR RAKED

Dentist (General Practice)