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

Jun Sang Park

Individual provider Periodontics · NPI 1770210254

Jun Sang Park is a Periodontics in Los Angeles, California. Practices as a sole proprietor. Licensed in California.

Licensed in
CA
In the registry since
2022
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Practice location Address checks out

4220 W 3rd St
Los Angeles, CA 90020-3450
Phone: (209) 518-2095
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Periodontics (primary) Taxonomy 1223P0300X · Licence DDS107513 (CA)

Record details

NPI number1770210254
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedAugust 4, 2022
Last updated in NPPESAugust 4, 2022
Certification dateAugust 4, 2022

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