Jun Sup Park, DDS
NPI 1669907663ActiveIndividual· Dentist· Downey, CA
Dentist (DDS) in Downey, California, licensed in CA and MI, with an NPI issued in April 2017. Part D covered 13 prescriptions written in 2024, 92% of them generic.
Overview
| NPI | 1669907663 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | DDS |
| Sole proprietor | No |
| NPI issued | Apr 27, 2017 |
| Last updated in NPPES | Aug 19, 2022 |
| Certified by provider | Aug 17, 2022 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Dentist Primary | 122300000X | 107810 | CA |
| Dentist | 122300000X | 2901022211 | MI |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 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) | 13 · 13 30-day fills |
|---|---|
| Total drug cost | $56.28 |
| Generic share | 92% 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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