Doctor profile · Federal record
Dr. Jae Park, DMD, PHD
Orthodontics and Dentofacial Orthopedic Dentist · Phoenix, AZ
- NPI 1811065238
- 20 yrs on file
- Male
- Group practice
- No sanctions
Practice & contact
- Primary practice
-
3155 W Indian School RD, Western Dental Orthodontic Office
Phoenix, AZ 850174035
(480) 286-0455 - Mailing address
-
5519 E Beryl Ave
Paradise Valley, AZ 852531165
Credentials & registration
- NPI registered
- December 2006 — 20 yrs on file
- Profile last updated
- July 8, 2007
- Specialty taxonomy
- 1223X0400X — NUCC code
- State license (1)
- Arizona #7019
Federal sanctions & exclusions
No sanctions, exclusions or revocations on file
Checked against OIG LEIE on NPI 1811065238. Last verified May 11, 2026.Open Payments
Industry payments received
All-time total
$78
Transactions
2
Manufacturers
2
| Payer (manufacturer) | Industry | Txns | Amount |
|---|---|---|---|
| Abbott Laboratories | 1 | $52.48 | |
| PAINTEQ LLC | 1 | $25.88 |
By nature of payment
Frequently asked questions
What is Dr. Jae Park's medical specialty?
Dr. Jae Park practices Orthodontics and Dentofacial Orthopedic Dentist in Phoenix, AZ.
Where does Dr. Jae Park practice?
Dr. Jae Park practices at 3155 W Indian School RD, Phoenix, AZ 850174035. Office phone: 4802860455.
What is Dr. Jae Park's NPI?
Dr. Jae Park's National Provider Identifier (NPI) is 1811065238, issued by NPPES.