Dr Hyunkyu Park, DMD is a medicare enrolled "Student In An Organized Health Care Education/training Program" provider in Detroit, Michigan. His current practice location is
22201 Moross Rd Ste 155, Detroit, Michigan. You can reach out to his office (for appointments etc.) via phone at
(313) 499-4775.
Dr Hyunkyu Park is licensed to practice in * (Not Available) (license number ) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1851943674.
Healthcare Provider's Profile
| Full Name | Dr Hyunkyu 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 | 22201 Moross Rd Ste 155, Detroit, Michigan |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1851943674
- Provider Enumeration Date: 07/11/2019
- Last Update Date: 08/07/2025
Medicare PECOS Information:
- PECOS PAC ID: 3375900756
- Enrollment ID: I20230530001844
Medical Identifiers
Medical identifiers for Dr Hyunkyu Park such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1851943674 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 122300000X | Dentist | 2901601710 (Michigan) | Secondary |
| 390200000X | Student In An Organized Health Care Education/training Program | (* (Not Available)) | Primary |
| 122300000X | Dentist | 30.026852 (Ohio) | Secondary |
| 122300000X | Dentist | D13889 (Minnesota) | Secondary |
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 Hyunkyu Park is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Dr Hyunkyu Park, DMD
22201 Moross Rd Ste 155,
Detroit, MI 48236-2152
Ph: (313) 499-4775 | Dr Hyunkyu Park, DMD
22201 Moross Rd Ste 155,
Detroit, MI 48236-2152
Ph: (313) 499-4775 |
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