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YONG TAE PARK
NPI 1952969354
Dentist - Endodontics in Elk Grove, CA

Active since May 31, 2019PECOS Enrolled
9184 E STOCKTON BLVD STE A, ELK GROVE, CA 95624(201) 835-6802 Get Directions Write a Review

NPPES record last updated: April 16, 2023. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Apr 16, 2023, Jul 18, 2022, May 31, 2019 (3 updates tracked since 2019).

About Yong Tae Park NPPES

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

YONG TAE PARK (NPI 1952969354) is an individual endodontics provider in Elk Grove, California, licensed in California (DDS103561) and active in the NPI registry since May 2019. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1952969354
Entity TypeIndividualMale
Primary Taxonomy1223E0200X
Provider Legal NameYONG TAE PARK
Location Address9184 E STOCKTON BLVD STE AElk Grove, CA 95624-9510
Mailing Address9184 E Stockton Blvd Ste AElk Grove, CA 95624-9510 · (201) 835-6802
Phone(201) 835-6802
Sole ProprietorNo
Enumeration DateMay 31, 2019
Last NPPES UpdateApril 16, 20233 updates tracked since enumeration
NPPES CertifiedApril 16, 2023
✔ NPI 1952969354 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · EndodonticsDental Providers
Taxonomy Code1223E0200X
License✔ Licensed in CA · DDS103561
Definition
The branch of dentistry that is concerned with the morphology, physiology and pathology of the human dental pulp and periradicular tissues. Its study and practice encompass the basic and clinical sciences including biology of the normal pulp, the etiology, diagnosis, prevention and treatment of diseases and injuries of the pulp and associated periradicular conditions.
9184 E STOCKTON BLVD STE A, Elk Grove, CA 95624
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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)

Yong Tae 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 95624 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
$92.61 typical visit price
range $60.44 – $180.85
Typical copayment $23.15 (range $15.11 – $45.21)
Most-billed visit code 99203
Established Patient
$75.03 typical visit price
range $19.88 – $148.15
Typical copayment $18.75 (range $4.97 – $37.03)
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 2

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

SURUCHI MALPANI DDS
Dentist
9184 E STOCKTON BLVD STE A
ELK GROVE, CA 95624
Sacramento County (415) 375-5580
TAVALLAEI, D.M.D., CORPORATION
Dentist (Pediatric Dentistry)
9184 E STOCKTON BLVD STE A
ELK GROVE, CA 95624
Sacramento County (916) 271-3737

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 Yong Tae Park's NPI number?

The NPI number for Yong Tae Park is 1952969354. It was assigned to this individual provider in the NPPES registry on May 31, 2019.

Where is Yong Tae Park located?

Yong Tae Park practices at 9184 E Stockton Blvd Ste A, Elk Grove, CA 95624. The listed phone number is (201) 835-6802.

What is Yong Tae Park's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Endodontics, with taxonomy code 1223E0200X.

Is Yong Tae Park enrolled in Medicare?

Yes. Yong Tae Park is registered in the Medicare PECOS enrollment system.

What insurance does Yong Tae 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 6 other insurers list Yong Tae 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 Yong Tae Park was last updated on April 16, 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.