Youngmin Park
Student in an Organized Health Care Education/Training Program in New York, NY. Individual provider (NPI-1).
NPI number1457054447
StatusActive
Last updated in NPPESJul 2, 2026
Details
- NPI
- 1457054447
- Entity type
- Individual (NPI-1)
- Name
- Youngmin Park
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Mar 27, 2023
- Certification date
- Jul 2, 2026
- Last updated
- Jul 2, 2026
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 390200000X | Student in an Organized Health Care Education/Training Program | – | – | Yes |
| 204E00000X | Oral & Maxillofacial Surgery | 70115953 | WA |
Practice location
622 W 168th StNew York, NY 10032-3720
Phone 212-305-6100
Mailing address
1959 Ne Pacific Street Box 357134Seattle, WA 98195-0001
Other practice locations
1959 Ne Pacific Street Box 357134
Seattle, WA 98195-0001
Seattle, WA 98195-0001
Phone 619-587-9820
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