Sohyun Stephanie Park, DMD in South Pasadena, CA

Sohyun Stephanie Park, DMD is a medicare enrolled "Dentist - Prosthodontics" provider in South Pasadena, California. Her current practice location is 627 Fremont Ave, South Pasadena, California. You can reach out to her office (for appointments etc.) via phone at (626) 799-6255.

Sohyun Stephanie Park is licensed to practice in Ohio (license number 30.027371) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1427424068.

Contact Information

	Sohyun Stephanie Park, DMD
	627 Fremont Ave, South Pasadena, CA 91030-2527
	(626) 799-6255
	Not Available

Map and Direction

Healthcare Provider's Profile

Full Name	Sohyun Stephanie Park
Gender	Female
Speciality	Dentist - Prosthodontics
Location	627 Fremont Ave, South Pasadena, California
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1427424068
Provider Enumeration Date: 08/18/2015
Last Update Date: 04/04/2024

Medicare PECOS Information:

PECOS PAC ID: 0446694954
Enrollment ID: I20240222002850

Medical Identifiers

Medical identifiers for Sohyun Stephanie Park such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1427424068	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
122300000X	Dentist	DN1857026 (Massachusetts)	Secondary
1223P0700X	Dentist - Prosthodontics	102415 (California)	Secondary
1223P0700X	Dentist - Prosthodontics	30.027371 (Ohio)	Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Sohyun Stephanie Park allows following entities to bill medicare on her behalf.

Entity Name	The Cleveland Clinic Foundation
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1679525919 PECOS PAC ID: 1850203555 Enrollment ID: O20031103000049

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. Sohyun Stephanie Park is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Sohyun Stephanie Park, DMD 11311 La Grange Ave Apt 327, Los Angeles, CA 90025-6868 Ph: (225) 439-3940	Sohyun Stephanie Park, DMD 627 Fremont Ave, South Pasadena, CA 91030-2527 Ph: (626) 799-6255

Reviews and Comments

Dentist in South Pasadena, CA

Dr. Vincent John Tso, DMD Dentist Medicare: May Accept Medicare Assignments Practice Location: 627 Fremont Ave, South Pasadena, CA 91030 Phone: 626-799-6255
Dr. Kimberley W Wu, DMD, MS Dentist Medicare: Not Enrolled in Medicare Practice Location: 1427 Mission St, South Pasadena, CA 91030 Phone: 626-403-1800
Mrs. Linda Jane Yanaga, DDS Dentist Medicare: Not Enrolled in Medicare Practice Location: 1421 Indiana Ave, South Pasadena, CA 91030 Phone: 323-344-0661 Fax: 323-344-0555
Dr. Pai-jen Boren Chen, D.D.S. Dentist Medicare: Not Enrolled in Medicare Practice Location: 1414 Fair Oaks Ave Ste 9, South Pasadena, CA 91030 Phone: 626-441-0899 Fax: 626-441-0885
Dr. James Carlton Hodge Jr., D.D.S. Dentist Medicare: Not Enrolled in Medicare Practice Location: 1941 Huntington Dr, Suite H, South Pasadena, CA 91030 Phone: 626-441-1139 Fax: 626-441-1233
Dr. Tony S Hwang, DDS Dentist Medicare: Not Enrolled in Medicare Practice Location: 1941 Huntington Dr, Suite #a, South Pasadena, CA 91030 Phone: 626-308-1807
Daniel Yacobi, DMD Dentist Medicare: Not Enrolled in Medicare Practice Location: 1140 Fremont Ave, South Pasadena, CA 91030 Phone: 626-441-6234 Fax: 626-799-1263

Sohyun Stephanie Park, DMD - Medicare Dentist in South Pasadena, CA