Sooh Park, - Medicare Dentist in Yucaipa, CA

Sooh Park, is a medicare enrolled "Dentist - General Practice" provider in Yucaipa, California. Her current practice location is 34880 Yucaipa Blvd, Yucaipa, California. You can reach out to her office (for appointments etc.) via phone at (909) 797-1136.

Sooh Park is licensed to practice in California (license number 63849) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1477956175.

Contact Information

Sooh Park,
34880 Yucaipa Blvd,
Yucaipa, CA 92399-4235
(909) 797-1136
Not Available



Healthcare Provider's Profile

Full NameSooh Park
GenderFemale
SpecialityDentist - General Practice
Location34880 Yucaipa Blvd, Yucaipa, California
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1477956175
  • Provider Enumeration Date: 10/08/2014
  • Last Update Date: 01/06/2022
  Medicare PECOS Information:
  • PECOS PAC ID: 2860770815
  • Enrollment ID: I20161026002833

Medical Identifiers

Medical identifiers for Sooh Park such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1477956175NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
122300000XDentist 63849 (California)Secondary
1223G0001XDentist - General Practice 63849 (California)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. Sooh 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 AddressPractice Location Address
Sooh Park,
34880 Yucaipa Blvd,
Yucaipa, CA 92399-4235

Ph: () -
Sooh Park,
34880 Yucaipa Blvd,
Yucaipa, CA 92399-4235

Ph: (909) 797-1136

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Dentist in Yucaipa, CA

Dr. Neal Antonio Johnson, DDS
Dentist
Medicare: Not Enrolled in Medicare
Practice Location: 34366 Yucaipa Blvd Ste K, Yucaipa, CA 92399
Phone: 909-797-9247    Fax: 909-354-3767
Steven Mark Wolfram, DDS
Dentist
Medicare: Not Enrolled in Medicare
Practice Location: 11834 Bryant St, Suite #104, Yucaipa, CA 92399
Phone: 909-797-1452    Fax: 909-790-0702
Dr. Mauricio Dossantos, DDS
Dentist
Medicare: Not Enrolled in Medicare
Practice Location: 12033 4th St Ste 7, Yucaipa, CA 92399
Phone: 909-790-1951    Fax: 909-790-1561
Dr. Richard Robert Ramos, D.D.S.
Dentist
Medicare: Medicare Enrolled
Practice Location: 34636 County Line Rd Ste 19, Yucaipa, CA 92399
Phone: 909-795-2585    Fax: 909-795-0046
Dr. Nathaniel Wen-wei Leng, D.D.S
Dentist
Medicare: Medicare Enrolled
Practice Location: 34880 Yucaipa Blvd, Yucaipa, CA 92399
Phone: 909-797-1136    
Dr. Craig Jackson Wright, D.D.S.
Dentist
Medicare: Not Enrolled in Medicare
Practice Location: 33490 Oak Glen Rd Ste F, Yucaipa, CA 92399
Phone: 909-790-9300    Fax: 909-797-2600
Dr. Sudhakar R Chokka, DDS
Dentist
Medicare: Medicare Enrolled
Practice Location: 34880 Yucaipa Blvd, Yucaipa, CA 92399
Phone: 909-797-1136    Fax: 909-797-9866

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