Eric Song Joon Park, D.D.S.
NPI 1356560916ActiveIndividual· Dentist, General Practice· South Lake Tahoe, CA
Dentist, General Practice (D.D.S.) in South Lake Tahoe, California, licensed in CA and NV, with an NPI issued in April 2007. Part D covered 125 prescriptions written in 2024, 99% of them generic.
Overview
| NPI | 1356560916 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | D.D.S. |
| Sole proprietor | Yes |
| NPI issued | Apr 24, 2007 |
| Last updated in NPPES | Jul 8, 2007 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Dentist, General Practice Primary | 1223G0001X | 48533 | CA |
| Dentist, General Practice | 1223G0001X | 4852 | NV |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Not in the public enrollment file of Oct 1, 2026 |
|---|
Part D prescriptions in 2024
| Prescriptions (claims) | 125 · 125 30-day fills |
|---|---|
| Patients | 96 |
| Total drug cost | $2,509 |
| Generic share | 99% of claims |
Industry payments (Open Payments)
None reported for 2025 or 2024.
Receiving payments does not imply wrongdoing. What Open Payments covers ·original records
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All 16 general dentists in South Lake Tahoe · All general dentists in California