Jonathan J Park
Oral and Maxillofacial Surgeon
10530 Rosehaven St Suite 111
Fairfax
, Virginia 22030-2840
Jonathan J Park
Oral and Maxillofacial Surgeon
10530 Rosehaven St Suite 111
Fairfax
, Virginia 22030-2840
(703) 591-5386
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About
Features
Specialties
- Oral and Maxillofacial Surgeon
Languages spoken
- English
Location
First Address
- Jonathan J Park
- 10530 Rosehaven St Suite 111
- Fairfax, VA
- Zip : 22030-2840
- Fax : (703) 591-5386
- Phone : (703) 385-5777
Second Address
- Jonathan J Park
- 10530 Rosehaven St Suite 111
- Fairfax, VA
- Zip : 22030-2840
- Fax : (703) 591-5386
- Phone : (703) 385-5777
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 1223S0112X | Oral and Maxillofacial Surgeon | 0101221324 | VA |
National Provider Identifier
| NPI | 1114940905 |
|---|---|
| Provider Name | Jonathan J Park |
| First Address | Fairfax, VA 22030-2840 |
| Second Address | Fairfax, VA 22030-2840 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 25/07/2006 |
| Last Update Date | 08/07/2007 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.