John Juwon Park, DMD in Albany, NY - Medicare Dentist Provider

John Juwon Park, DMD is a medicare enrolled "Dentist - Pediatric Dentistry" provider in Albany, New York. His current practice location is 4 Executive Park Dr, Albany, New York. You can reach out to his office (for appointments etc.) via phone at (347) 408-8673.

John Juwon Park is licensed to practice in New York (license number 056491) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1083866982.

Contact Information

	John Juwon Park, DMD
	4 Executive Park Dr, Albany, NY 12203
	(347) 408-8673
	Not Available

Healthcare Provider's Profile

Full Name	John Juwon Park
Gender	Male
Speciality	Dentist - Pediatric Dentistry
Location	4 Executive Park Dr, Albany, New York
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1083866982
Provider Enumeration Date: 10/22/2008
Last Update Date: 05/17/2018

Medicare PECOS Information:

PECOS PAC ID: 9537438049
Enrollment ID: I20170627000085

Medical Identifiers

Medical identifiers for John Juwon Park such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1083866982	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
1223P0221X	Dentist - Pediatric Dentistry	056491 (New York)	Primary

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. John Juwon Park is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
John Juwon Park, DMD 255 Patroon Creek Blvd Apt 1405, Albany, NY 12206-5019 Ph: (347) 408-8673	John Juwon Park, DMD 4 Executive Park Dr, Albany, NY 12203 Ph: (347) 408-8673

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John Juwon Park, DMD - Medicare Dentist in Albany, NY