Jonathan J Park, DMD,MD - Dentist in Fairfax, VA

Jonathan J Park, DMD,MD is a Dentist - Oral And Maxillofacial Surgery based in Fairfax, Virginia. Jonathan J Park is licensed to practice in Virginia (license number 0101221324) and his current practice location is 10530 Rosehaven St, Suite 111, Fairfax, Virginia. He can be reached at his office (for appointments etc.) via phone at (703) 385-5777.

NPI number for Jonathan J Park is 1114940905 and his current mailing address is 10530 Rosehaven St, Suite 111, Fairfax, Virginia. He does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1114940905.

Contact Information

Jonathan J Park, DMD,MD
10530 Rosehaven St, Suite 111,
Fairfax, VA 22030-2840
(703) 385-5777
(703) 591-5386

Map and Direction




Healthcare Provider's Profile

Full NameJonathan J Park
GenderMale
SpecialityDentist - Oral And Maxillofacial Surgery
Location10530 Rosehaven St, Fairfax, Virginia
Accepts Medicare AssignmentsDoes not participate in Medicare Program. He may not accept medicare assignment.
  NPI Data:
  • NPI Number: 1114940905
  • Provider Enumeration Date: 07/25/2006
  • Last Update Date: 07/08/2007

Medical Identifiers

Medical identifiers for Jonathan J Park such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1114940905NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
1223S0112XDentist - Oral And Maxillofacial Surgery 0101221324 (Virginia)Primary

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Jonathan J Park is NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Jonathan J Park, DMD,MD
10530 Rosehaven St, Suite 111,
Fairfax, VA 22030-2840

Ph: (703) 385-5777
Jonathan J Park, DMD,MD
10530 Rosehaven St, Suite 111,
Fairfax, VA 22030-2840

Ph: (703) 385-5777

Reviews and Comments


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