Sooh Park
NPI 1477956175ActiveIndividual· Dentist, General Practice· Yucaipa, CA
Dentist, General Practice in Yucaipa, California, licensed in CA, with an NPI issued in October 2014. Part D covered 27 prescriptions written in 2024, 100% of them generic.
Overview
| NPI | 1477956175 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Sole proprietor | No |
| NPI issued | Oct 8, 2014 |
| Last updated in NPPES | Jan 6, 2022 |
| Certified by provider | Jan 6, 2022 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Dentist, General Practice Primary | 1223G0001X | 63849 | CA |
| Dentist | 122300000X | 63849 | CA |
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) | Enrolled Order and Referring Only - Dentist (CA) |
|---|
Part D prescriptions in 2024
| Prescriptions (claims) | 27 · 27 30-day fills |
|---|---|
| Patients | 16 |
| Total drug cost | $132.54 |
| Generic share | 100% 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 19 general dentists in Yucaipa · All general dentists in California