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

Jung Won Park, DDS

Individual provider Dentist · NPI 1043983364

Jung Won Park, DDS is a Dentist in Tyler, Texas. Licensed in Texas. Registered with an NPI since 2021.

Licensed in
TX
In the registry since
2021
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

212 Old Grande Blvd Ste B224
Tyler, TX 75703-4277
Phone: (903) 509-0505
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Dentist (primary) Taxonomy 122300000X · Licence 37630 (TX)

Record details

NPI number1043983364
Entity typeIndividual (Type 1)
GenderMale
Credentials DDS
Sole proprietorNo
NPI enumeratedAugust 2, 2021
Last updated in NPPESAugust 2, 2021
Certification dateAugust 2, 2021
Mailing address11 S Mill St Ste 200, New Castle, PA 16101-3680

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