DR. IN KOOK PARK DMD NPI 1053485060

NPI Information

  • NPI: 1053485060
  • Provider Name: DR. IN KOOK PARK, DMD
  • Classification: Dentist - 1223G0001X
  • Specialization: General Practice
  • Entity Type: Individual
  • Address: 1732 DEKALB PIKE
    BLUE BELL, PA
    ZIP 19422
  • Phone: (610) 278-1110

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NPI Details

DR. In Kook Park, DMD is a general practice dentist in Blue Bell, PA. The provider is a general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. DR. In Kook Park, DMD NPI is 1053485060. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

1732 DEKALB PIKE
BLUE BELL, PA
ZIP 19422-352
Phone: (610) 278-1110
Fax: (610) 278-1852

The enumeration date for this NPI number is 11/20/2006 and was last updated on 10/18/2008.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
11223G0001XDentistGeneral PracticeDS035609PENNSYLVANIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1101079572MEDICAIDPENNSYLVANIA
2101079572MEDICARE ID-TYPE UNSPECIFIEDPENNSYLVANIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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