Dr Scott Juyoung Park, DMD is a
Student In An Organized Health Care Education/training Program based in Augusta, Georgia. Dr Scott Juyoung Park is licensed to practice in Georgia (license number DN122376) and his current practice location is
1430 John Wesley Gilbert Drive, Augusta, Georgia. He can be reached at his office (for appointments etc.) via phone at
(706) 721-2371.
NPI number for Dr Scott Juyoung Park is 1376114207 and his current mailing address is 4632 Dandelion Cir Ne, Marietta, Georgia. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1376114207.
Healthcare Provider's Profile
Full Name | Dr Scott Juyoung Park |
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Gender | Male |
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Speciality | Student In An Organized Health Care Education/training Program |
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Location | 1430 John Wesley Gilbert Drive, Augusta, Georgia |
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Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
NPI Data:
- NPI Number: 1376114207
- Provider Enumeration Date: 07/01/2021
- Last Update Date: 06/30/2023
Medical Identifiers
Medical identifiers for Dr Scott Juyoung Park such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1376114207 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
1223G0001X | Dentist - General Practice | 019.033440 (Illinois) | Secondary |
1223G0001X | Dentist - General Practice | 1002618-15 (Wisconsin) | Secondary |
1223G0001X | Dentist - General Practice | DN122376 (Georgia) | Secondary |
390200000X | Student In An Organized Health Care Education/training Program | DN122376 (Georgia) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Scott Juyoung Park is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Dr Scott Juyoung Park, DMD 4632 Dandelion Cir Ne, Marietta, GA 30067-3660 Ph: (404) 313-6654 | Dr Scott Juyoung Park, DMD 1430 John Wesley Gilbert Drive, Augusta, GA 30912-3947 Ph: (706) 721-2371 |
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