Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Dr. Jaeyoun Park, DDS

Individual provider General Practice Dentistry · NPI 1679252647

Dr. Jaeyoun Park, DDS is a General Practice Dentistry in Cleveland, Tennessee. Licensed in Tennessee. Registered with an NPI since 2023.

Licensed in
TN
In the registry since
2023
What do these letters mean?
DDS — Doctor of Dental Surgery
A dentist. DDS and DMD are the same qualification — universities choose which title to award.

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Practice location Address checks out

609 Paul Huff Pkwy NW
Cleveland, TN 37312-2970
Phone: (318) 233-6077
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

General Practice Dentistry (primary) Taxonomy 1223G0001X · Licence 12232 (TN)

Record details

NPI number1679252647
Entity typeIndividual (Type 1)
GenderMale
Credentials DDS
Sole proprietorNo
NPI enumeratedJuly 17, 2023
Last updated in NPPESJuly 17, 2023
Certification dateJuly 15, 2023
Mailing address7219 Aventine Way Apt 303, Chattanooga, TN 37421-4180

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