Jaechan Park, DDS - Medicare Dentist in Gardena, CA

Jaechan Park, DDS is a medicare enrolled "Dentist - General Practice" provider in Gardena, California. His current practice location is 15201 S Western Ave, Gardena, California. You can reach out to his office (for appointments etc.) via phone at (310) 400-7705.

Jaechan Park is licensed to practice in California (license number 49972) 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 1275666315.

Contact Information

Jaechan Park, DDS
15201 S Western Ave,
Gardena, CA 90249-4314
(310) 400-7705
Not Available

Map and Direction




Healthcare Provider's Profile

Full NameJaechan Park
GenderMale
SpecialityDentist - General Practice
Location15201 S Western Ave, Gardena, California
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1275666315
  • Provider Enumeration Date: 03/14/2007
  • Last Update Date: 03/13/2023
  Medicare PECOS Information:
  • PECOS PAC ID: 7315248887
  • Enrollment ID: I20151229001410

Medical Identifiers

Medical identifiers for Jaechan Park such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1275666315NPI-NPPES
1687022OtherPAUNITED CONCORDIA
G92988-01OtherCADENTICAL
1581480MedicaidAK
B49972-01OtherCAHEALTHY FAMILY
D49972OtherCADENTICAL-RENDERING ID

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
1223G0001XDentist - General Practice 49972 (California)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. Jaechan 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 AddressPractice Location Address
Jaechan Park, DDS
614 Inverness Ct,
Fullerton, CA 92835-2776

Ph: (626) 454-0159
Jaechan Park, DDS
15201 S Western Ave,
Gardena, CA 90249-4314

Ph: (310) 400-7705

Reviews and Comments


Dentist in Gardena, CA

Yan Yampolsky, DMD
Dentist
Medicare: Not Enrolled in Medicare
Practice Location: 1210 W Redondo Beach Blvd, Gardena, CA 90247
Phone: 310-523-9009    
Dr. Harry C Kim, DDS
Dentist
Medicare: Medicare Enrolled
Practice Location: 15400 Crenshaw Blvd, Gardena, CA 90249
Phone: 310-516-9858    Fax: 310-516-9658
Dr. Dung N Nguyen, DDS
Dentist
Medicare: Not Enrolled in Medicare
Practice Location: 16229 S Western Ave, Gardena, CA 90247
Phone: 310-515-2875    
Dr. Rose Marie Baniqued Quimson, D.D.S.
Dentist
Medicare: Not Enrolled in Medicare
Practice Location: 2926 Marine Ave, Gardena, CA 90249
Phone: 310-538-4496    Fax: 310-538-4495
Dr. Abier Abdulwahab, DDS
Dentist
Medicare: Not Enrolled in Medicare
Practice Location: 15506 Ermanita Ave, Gardena, CA 90249
Phone: 714-467-8555    
Dr. Maria Teresa Mantuano Yepiz, DENTIST
Dentist
Medicare: Medicare Enrolled
Practice Location: 1451 W Artesia Blvd, Suite 6, Gardena, CA 90248
Phone: 310-323-0290    
Dr. Jeffrey Yasunori Yamashiro, DDS
Dentist
Medicare: Not Enrolled in Medicare
Practice Location: 1605 W Redondo Beach Blvd, Suite #203, Gardena, CA 90247
Phone: 310-329-1312    Fax: 310-329-1074

Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.