Type 1 · Individual ✓ Active NPI ✓ Valid NPI checksum

Jung Won Park, DDS

Dentist in Tyler, TX · enumerated 2021 · practices at Professional Dental Alliance of Tx 43004 Pllc.

Data current as of Jul 13, 2026 · sourced from CMS NPPES

National Provider Identifier

1043983364

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Registry record

Entity type Individual (Type 1)

Name Jung Won Park

Credential DDS

Sex Male

Practice address 212 Old Grande Blvd Ste B224, Tyler, TX, 75703

Phone (903) 509-0505

Enumeration date Aug 2, 2021

Last updated in NPPES Aug 2, 2021

Taxonomy & licenses

122300000X Dentist Dental Providers · License 37630 (TX) Primary

DDS · Doctor of Dental Surgery: A licensed dentist; DDS and DMD are equivalent dental degrees. About the DDS credential

What is an NPI number?

A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes, even if the provider moves or changes specialty.

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Frequently asked questions

How do I verify Jung Won Park's NPI record?

Cross-check NPI 1043983364 against the official CMS registry at npiregistry.cms.hhs.gov. This page mirrors the same public NPPES data with a monthly snapshot.

Is NPI 1043983364 active?

Yes, as of the latest NPPES snapshot, NPI 1043983364 is active (record last updated 2021-08-02).

Other providers at this practice address

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Professional Dental Alliance of Tx 43004 Pllc General Practice Dentistry · Tyler, TX NPI 1093329534 Naga Azzarapu Dentist · Tyler, TX NPI 1588337679 Janaki Khot Orthodontics and Dentofacial Orthopedics Dentistry · Tyler, TX NPI 1689551665 Bruna Kennedy General Practice Dentistry · Tyler, TX NPI 1174445621

Source: CMS NPPES (public data). Snapshot 2026-07-13. Provider record last updated 2021-08-02.