JOOYEON PARK DMD
NPI 1699392316
Dentist in Philadelphia, PA

Q: What is Jooyeon Park's NPI number?

The NPI number for Jooyeon Park is 1699392316. It was assigned to this individual provider in the NPPES registry on June 29, 2020.

Q: What is Jooyeon Park's specialty?

The primary specialty registered for this NPI is Dentist with taxonomy code 122300000X.

Q: When was this NPI record last updated?

The NPPES record for Jooyeon Park was last updated on March 29, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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 June 29, 2020PECOS Enrolled

1207 CHESTNUT ST FL 4, PHILADELPHIA, PA 19107(215) 525-3046(215) 309-1133 Get Directions Write a Review

NPPES record last updated: March 29, 2023. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Mar 29, 2023, Dec 1, 2022, Jun 29, 2020 (3 updates tracked since 2020).

On this page

About Jooyeon Park Dmd NPPES

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

JOOYEON PARK DMD (NPI 1699392316) is an individual dentist in Philadelphia, Pennsylvania, licensed in Pennsylvania (DS043036) and active in the NPI registry since June 2020. She is enrolled in Medicare PECOS and maintains a secondary practice location in Philadelphia.

NPPES Registry Identity

NPI1699392316

Entity TypeIndividualFemale

Primary Taxonomy122300000X

Provider Legal NameJOOYEON PARKCredential: DMD

Location Address1207 CHESTNUT ST FL 4Philadelphia, PA 19107-4131

Mailing Address1233 Locust St Fl 3Philadelphia, PA 19107-5400 · (215) 780-1809 · Fax (215) 309-1129

Phone(215) 525-3046

Fax(215) 309-1133

Sole ProprietorYes

Enumeration DateJune 29, 2020

Last NPPES UpdateMarch 29, 20233 updates tracked since enumeration

NPPES CertifiedMarch 29, 2023

✔ NPI 1699392316 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentistDental Providers

Taxonomy Code122300000X

License✔ Licensed in PA · DS043036

Definition

A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist.

1207 CHESTNUT ST FL 4, Philadelphia, PA 19107

Open in Google Maps ↗

Secondary Practice Location 1

Location 13900 Woodland AvePhiladelphia, PA 19104-4551 · Phone (215) 823-5800 ext. 2088

Other Identifiers 1

Medicaid104059920PA

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, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Jooyeon 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.

Medicare Billing Reassignment

Medicare enrollment records show Jooyeon Park reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Philadelphia Fight

0.2 mi

Federally Qualified Health Center (FQHC)

1233 LOCUST ST FL 4
Philadelphia, PA 19107

Reassigned Medicare billing, Pennsylvania enrollment
44 clinicians in this Medicare group

NPI 1487082608 (215) 790-1788

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 19107 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

$92.69 typical visit price

range $59.88 – $180.99

Typical copayment $23.17 (range $14.97 – $45.24)

Most-billed visit code 99203

Established Patient

$74.47 typical visit price

range $19.30 – $147.29

Typical copayment $18.61 (range $4.82 – $36.82)

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 4

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

FAYE SITRON

Dental Hygienist

1207 CHESTNUT ST FL 4
PHILADELPHIA, PA 19107

Philadelphia County (215) 545-3046

DR. KARI R HEXEM DMD

Dentist (General Practice)

1207 CHESTNUT ST FL 4
PHILADELPHIA, PA 19107

Philadelphia County (215) 525-3046

PATRINA PAGE RDH, PHDHP

Dental Hygienist

1207 CHESTNUT ST FL 4
PHILADELPHIA, PA 19107

Philadelphia County (215) 525-3046

DANIEL MARICHE-POIROT DMD

Dentist (General Practice)

1207 CHESTNUT ST FL 4
PHILADELPHIA, PA 19107

Philadelphia County (215) 525-3046

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 Jooyeon Park's NPI number?

The NPI number for Jooyeon Park is 1699392316. It was assigned to this individual provider in the NPPES registry on June 29, 2020.

Where is Jooyeon Park located?

Jooyeon Park practices at 1207 Chestnut St Fl 4, Philadelphia, PA 19107. The listed phone number is (215) 525-3046.

What is Jooyeon Park's specialty?

The primary specialty registered for this NPI is Dentist with taxonomy code 122300000X.

Is Jooyeon Park enrolled in Medicare?

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

Which organization bills Medicare for Jooyeon Park's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Jooyeon Park reassigns Medicare benefits to Philadelphia Fight (Philadelphia, PA). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Jooyeon Park's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Jooyeon Park accept?

Health plans from BEST Life, Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma, Blue Cross and Blue Shield of Texas and EMI Health and 5 other insurers list Jooyeon 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 Jooyeon Park was last updated on March 29, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.