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

Yong Tae Park

Individual provider Endodontics · NPI 1952969354

Yong Tae Park is an Endodontics in Elk Grove, California. Licensed in California. Registered with an NPI since 2019.

Licensed in
CA
In the registry since
2019
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Practice location Address checks out

9184 E Stockton Blvd Ste A
Elk Grove, CA 95624-9510
Phone: (201) 835-6802
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Endodontics (primary) Taxonomy 1223E0200X · Licence DDS103561 (CA)

Record details

NPI number1952969354
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedMay 31, 2019
Last updated in NPPESApril 16, 2023
Certification dateApril 16, 2023

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