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

Individual provider Dentist · NPI 1073526794

Renee Yoosun Park, DDS is a Dentist in San Diego, California. Practices as a sole proprietor. Licensed in California and New York.

Licensed in
CA, NY
In the registry since
2006
Specialties on file
2
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

10255 Black Mountain Rd #P4
San Diego, CA 92126-3866
Phone: (510) 290-2260
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Dentist (primary) Taxonomy 122300000X · Licence 54005 (CA)
Dentist Taxonomy 122300000X · Licence 055807-1 (NY)

Record details

NPI number1073526794
Entity typeIndividual (Type 1)
GenderFemale
Credentials DDS
Sole proprietorYes
NPI enumeratedAugust 14, 2006
Last updated in NPPESApril 22, 2014

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