DR. SE HA PARK DMD
NPI 1821611989
Dentist in Jbsa Lackland, TX

Active since May 24, 2020
2133 PEPPERRELL ST BLDG 3352, JBSA LACKLAND, TX 78236(210) 292-6258 Get Directions Write a Review

NPPES record last updated: July 14, 2025. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Aug 2, 2022, May 24, 2020 (2 updates tracked since 2020).

About Dr. Se Ha Park Dmd NPPES

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

DR. SE HA PARK DMD (NPI 1821611989) is an individual dentist in Jbsa Lackland, Texas, licensed in Virginia (0401416968) and active in the NPI registry since May 2020.

NPPES Registry Identity

NPI1821611989
Entity TypeIndividualFemale
Primary Taxonomy122300000X
Provider Legal NameDR. SE HA PARKCredential: DMD
Location Address2133 PEPPERRELL ST BLDG 3352Jbsa Lackland, TX 78236-5313
Mailing Address633 S Saint Marys St Unit 6502San Antonio, TX 78205-1260 · (210) 292-6258
Sole ProprietorYes
Enumeration DateMay 24, 2020
Last NPPES UpdateJuly 14, 20252 updates tracked since enumeration
NPPES CertifiedJuly 14, 2025
NPI 1821611989 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

Primary SpecialtyDentistDental Providers
Taxonomy Code122300000X
License Licensed in VA · 0401416968
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.

Also ListedDentist · General PracticeTaxonomy 1223G0001X · License 0401416968 (VA)
2133 PEPPERRELL ST BLDG 3352, Jbsa Lackland, TX 78236

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Other Providers at the Same Location


The following 17 providers are registered at the same or a nearby location.

Dentist (General Practice)
2133 PEPPERRELL ST BLDG 3352, AF POSTGRADUATE DENTAL SCHOOL
LACKLAND A F B, TX 78236
Dentist
2133 PEPPERRELL ST BLDG 3352, 2133 PEPPERRELL STREET, BUILDING 3352
JBSA LACKLAND, TX 78236
Dentist (General Practice)
2133 PEPPERRELL ST BLDG 3352
JBSA LACKLAND, TX 78236
Dentist
2133 PEPPERRELL ST BLDG 3352
JBSA LACKLAND, TX 78236
Dentist (Orthodontics and Dentofacial Orthopedics)
2133 PEPPERRELL ST BLDG 3352
JBSA LACKLAND, TX 78236
Dentist (Orthodontics and Dentofacial Orthopedics)
2133 PEPPERRELL ST BLDG 3352
SAN ANTONIO, TX 78236
Dentist (Orthodontics and Dentofacial Orthopedics)
2133 PEPPERRELL ST BLDG 3352
JBSA LACKLAND, TX 78236
Dentist
2133 PEPPERRELL ST BLDG 3352
JBSA LACKLAND, TX 78236
Dentist
2133 PEPPERRELL ST BLDG 3352
JBSA LACKLAND, TX 78236
Dentist
2133 PEPPERRELL ST BLDG 3352
LACKLAND AFB, TX 78236
Dentist
2133 PEPPERRELL ST BLDG 3352
LACKLAND AFB, TX 78236
Dentist (General Practice)
2133 PEPPERRELL ST BLDG 3352
JBSA LACKLAND, TX 78236
Dentist
2133 PEPPERRELL ST BLDG 3352
JBSA LACKLAND, TX 78236
Dentist
2133 PEPPERRELL ST BLDG 3352
JBSA LACKLAND, TX 78236
Dentist (General Practice)
2133 PEPPERRELL ST BLDG 3352
SAN ANTONIO, TX 78236
Dentist (General Practice)
2133 PEPPERRELL ST BLDG 3352
LACKLAND AFB, TX 78236
Student in an Organized Health Care Education/Training Program
2133 PEPPERRELL ST BLDG 3352
SAN ANTONIO, TX 78236

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1821611989, enumerated as an "individual" on May 24, 2020.

The provider is located at 2133 PEPPERRELL ST BLDG 3352 JBSA LACKLAND, TX 78236 and the phone number is (210) 292-6258.

Dentist with taxonomy code 122300000X.