DR. JOHN I PARK DMD NPI 1295754018

NPI Information

NPI: 1295754018
Provider Name: DR. JOHN I PARK, DMD
Classification: Dentist - 1223G0001X
Specialization: General Practice
Entity Type: Individual
Address: 400 AVENUE K SE
STE 12
WINTER HAVEN, FL
ZIP 33880
Phone: (863) 293-0023

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NPI Details

DR. John I Park, DMD is a general practice dentist in Winter Haven, FL. 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. John I Park, DMD NPI is 1295754018. 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:

400 AVENUE K SE
STE 12
WINTER HAVEN, FL
ZIP 33880-145
Phone: (863) 293-0023

The enumeration date for this NPI number is 7/19/2006 and was last updated on 1/6/2017.

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
1	1223G0001X	Dentist	General Practice	DN14475	FLORIDA	Yes

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
1	59-355-5785	OTHER	FLORIDA	TAX ID NUMBER

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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