Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Jonathan J Park, DMD, MD

Individual provider Oral and Maxillofacial Surgery (Dentist) · NPI 1114940905

Jonathan J Park, DMD, MD is an Oral and Maxillofacial Surgery (Dentist) in Fairfax, Virginia. Licensed in Virginia. Registered with an NPI since 2006.

Licensed in
VA
In the registry since
2006
What do these letters mean?
DMD — Doctor of Dental Medicine
A dentist. Identical training and licensing to a DDS.
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

10530 Rosehaven St Ste 111
Fairfax, VA 22030-2840
Phone: (703) 385-5777
Fax: (703) 591-5386
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Specialties & licences

Oral and Maxillofacial Surgery (Dentist) (primary) Taxonomy 1223S0112X · Licence 0101221324 (VA)

Record details

NPI number1114940905
Entity typeIndividual (Type 1)
GenderMale
Credentials DMD , MD
Sole proprietorNo
NPI enumeratedJuly 25, 2006
Last updated in NPPESJuly 8, 2007
Mailing address10530 Rosehaven St, Suite 111, Fairfax, VA 22030-2840

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