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

Dr. SE Ha Park, DMD

Individual provider Dentist · NPI 1821611989

Dr. SE Ha Park, DMD is a Dentist in Jbsa Lackland, Texas. Practices as a sole proprietor. Licensed in Virginia.

Licensed in
VA
In the registry since
2020
Specialties on file
3
What do these letters mean?
DMD — Doctor of Dental Medicine
A dentist. Identical training and licensing to a DDS.

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Practice location Address checks out

2133 Pepperrell St Bldg 3352
Jbsa Lackland, TX 78236-5313
Phone: (210) 292-6258
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Dentist (primary) Taxonomy 122300000X · Licence 0401416968 (VA)
General Practice Dentistry Taxonomy 1223G0001X · Licence 0401416968 (VA)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1821611989
Entity typeIndividual (Type 1)
GenderFemale
Credentials DMD
Sole proprietorYes
NPI enumeratedMay 24, 2020
Last updated in NPPESJuly 14, 2025
Certification dateJuly 14, 2025
Mailing address633 S Saint Marys St Unit 6502, San Antonio, TX 78205-1260

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