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DR. JIM SANG PARK D.D.S
NPI 1912116104
Dentist in Riverside, CA

Active since May 22, 2007PECOS Enrolled
4710 LA SIERRA AVE, RIVERSIDE, CA 92505(951) 324-8180 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Dr. Jim Sang Park D.d.s NPPES

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

DR. JIM SANG PARK D.D.S (NPI 1912116104) is an individual dentist in Riverside, California, licensed in California (47545) and active in the NPI registry since May 2007. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1912116104
Entity TypeIndividualMale
Primary Taxonomy122300000X
Provider Legal NameDR. JIM SANG PARKCredential: D.D.S
Location Address4710 LA SIERRA AVERiverside, CA 92505-2726
Mailing Address11179 Bridgefield CtRiverside, CA 92505-2777
Phone(951) 324-8180
Sole ProprietorYes
Enumeration DateMay 22, 2007
Last NPPES UpdateJuly 8, 2007
✔ NPI 1912116104 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentistDental Providers
Taxonomy Code122300000X
License✔ Licensed in CA · 47545
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.
4710 LA SIERRA AVE, Riverside, CA 92505
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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 Montana 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)

Dr. Jim Sang Park D.d.s 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 92505 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 4

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

HO,NGUYEN,PARK DENTAL CORPORATION
Dentist
4710 LA SIERRA AVE
RIVERSIDE, CA 92505
Riverside County (951) 324-8180
WOOJUNG PARK
Dentist
4710 LA SIERRA AVE
RIVERSIDE, CA 92505
Riverside County (951) 324-8180
DR. SHEILA NIKDEL DDS
Dentist
4710 LA SIERRA AVE
RIVERSIDE, CA 92505
Riverside County (951) 324-8180
MOHAMMAD ALI ZAREH DDS INC
Dentist
4710 LA SIERRA AVE
RIVERSIDE, CA 92505
Riverside County (951) 324-8180

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 Jim Park's NPI number?

The NPI number for Jim Park is 1912116104. It was assigned to this individual provider in the NPPES registry on May 22, 2007.

Where is Jim Park located?

Jim Park practices at 4710 La Sierra Ave, Riverside, CA 92505. The listed phone number is (951) 324-8180.

What is Jim Park's specialty?

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

Is Jim Park enrolled in Medicare?

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

What insurance does Jim Park accept?

Health plans from Anthem Blue Cross and Blue Shield, BEST Life, Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma and Blue Cross and Blue Shield of Texas and 5 other insurers list Jim 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 Jim Park was last updated on July 8, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 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.