National Provider Identifier
Jisung Park, DDS
Jisung Park, DDS is listed in the NPPES registry with a primary specialty of Dentist in Buffalo, NY and a listed phone number of (716) 651-0099.
Profile Overview
- NPI
- 1346738564
- Provider Type
- Individual
- Primary Specialty
- Dentist
- Enumeration Date
- April 24, 2018
- Last Updated
- August 06, 2019
Practice Location
- 3557 Union RD
- Buffalo, NY 14225-5123
Phone: (716) 651-0099
Specialties
- Dentist (122300000X)
Full Record
- NPI
- 1346738564
- Entity Type
- Individual
- Last Name
- Park
- First Name
- Jisung
- Credential
- DDS
- Mailing Street Address
- 3557 Union RD
- Mailing City
- Buffalo
- Mailing State
- NY
- Mailing ZIP Code
- 14225-5123
- Mailing Country
- US
- Practice Street Address
- 3557 Union RD
- Practice City
- Buffalo
- Practice State
- NY
- Practice ZIP Code
- 14225-5123
- Practice Country
- US
- Practice Phone
- (716) 651-0099
- Enumeration Date
- April 24, 2018
- Last Updated
- August 06, 2019
- Sex
- Female
- Sole Proprietor
- Yes
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Dentist (122300000X)