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Jae H Park

Dentist β€’ Quantico, VA

Active NPI 1386110781 Individual Practitioner Male Practitioner
Practice location in NPPES

3259 Catlin Ave
Quantico, VA 221345109

Call 7579539000 Location details and other listings
Medical Disclaimer

This profile restates public CMS/NPPES data; T-MedInfo gives no medical advice — consult a licensed professional, and call 911 for emergencies.

Practice Location & Contact Primary Location

Practice Address

3259 Catlin Ave

Quantico, VA 221345109

Telephone 7579539000
Organization at the Same NPPES Address or Phone
Nhc Quantico Facility NPI 1508839903

Matched by practice address or phone in NPPES. A shared address or phone does not confirm that this clinician works there.

Industry payments (Open Payments)

Fewer than 11 payment records totaling $17.48 in 2025

Drug and medical device companies must report certain payments to doctors and some other clinicians to CMS, such as meals, travel, speaking fees or research funding.

These records are submitted by drug and medical device companies, and a reported payment does not necessarily mean the financial relationship is improper.

General: payments not tied to research, such as meals, travel, consulting or speaking fees.

A reported payment does not necessarily mean the financial relationship is improper. Research payments can go to a hospital or university for a study the clinician leads, not to the clinician personally. Clinicians can dispute records with the company that reported them.

Source: CMS Open Payments, program year 2025.

Guide: How to read an Open Payments record

NPI first issued

2018

The year this clinician's National Provider Identifier (NPI) was issued. An NPI is a unique 10-digit ID that US health care providers use for billing.

What this does not show: NPI first issued

NPIs have been issued only since 2005, so this year is not necessarily when the clinician started practicing.

Source: CMS NPPES NPI Registry.

Medicare assignment not listed

CMS data do not show whether this clinician accepts Medicare assignment. This does not mean they do not accept Medicare. Ask the office.

Medicare assignment applies to Original Medicare. It does not tell you whether the clinician is in a Medicare Advantage plan's network, accepts other insurance, or is taking new patients.

Source: CMS Doctors and Clinicians; Medicare.gov, β€œDoes your provider accept Medicare as full payment?”

Guide: What Medicare assignment means

No telehealth indicator

CMS shows this indicator only when recent Medicare claims include telehealth services. The clinician may still offer telehealth; ask the office.

Source: CMS, Telehealth Indicator on Medicare Care Compare (fact sheet, January 2023); CMS Doctors and Clinicians.

Guide: How Medicare covers telehealth

Compared with the same specialty in Quantico and Virginia

15 active clinicians are listed under Dentist with a practice address in Quantico, VA (2,405 in Virginia).

Addresses are self-reported to NPPES and may be out of date.

Telehealth indicator in Quantico

0% of these 15 clinicians have the CMS telehealth indicator.

0% of these 15 clinicians are listed by CMS as accepting Medicare assignment.

Sources: CMS Open Payments (2025), CMS Doctors and Clinicians, CMS NPPES NPI Registry. Specialty names follow the NUCC Health Care Provider Taxonomy.

Text: T-MedInfo Β· Report an error.

Pharma & Medical Device Financial Disclosures

Payments and other transfers of value that drug and medical device companies reported to CMS Open Payments

Open Payments Β· Program Year 2025

Program year 2025 (payments made January 1 – December 31, 2025): fewer than 11 records totaling $17.48.

Manufacturer Payment Nature Product Type Amount ($)
COLGATE ORAL PHARMACEUTICALS, INC.
Education
In-kind items and services
β€” General $17.48

Source: CMS Open Payments, program year 2025, released June 30, 2026.

Specialties & License Numbers Reported to NPPES

Self-certified to NPPES: 2023-02-28
Dentist Primary Specialty

NUCC Taxonomy Code: 122300000X

License # reported to NPPES VA 0401416211

A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist.

Check License Status with the State Board License numbers are self-reported to NPPES; T-MedInfo does not confirm them against state records. Current status: Virginia Department of Health Professions.
Look Up on State Board Site

Clinicians Sharing This Practice Address or Phone

Clinicians sharing this NPPES address, phone or fax; a shared contact does not mean they work together.

4 listed
Kristen Blandford , NP-C

Nurse Practitioner - Family

NPI 1972027373

Nurse Practitioner (Certified)

Patrick Donnelly , PA-C

Physician Assistant

NPI 1770994253

Physician Assistant (Certified)

Dr. Edward Leitz , MD

Internal Medicine

NPI 1467503722

Doctor of Medicine (M.D.)

Kelly Pilch , PA

Physician Assistant

NPI 1477787349

Physician Assistant

Career & Practice History Timeline

Changes recorded in monthly NPPES data files: addresses, names, credentials, specialties and NPI status

8 Historical Events
πŸ“
Updated Practice Location February 28, 2023

Registered at 3259 CATLIN AVE, QUANTICO, VA 221345109 (Tel: 7579539000)

πŸ“
Updated Business Mailing Address February 28, 2023

Registered at 2701 NEABSCO COMMON PL APT 519, WOODBRIDGE, VA 221916717 (Tel: 7032548008)

βœ…
NPI Profile Active October 23, 2018

NPI status registered as active in NPPES database

πŸ“
Practice Location (Initial Record) October 23, 2018

Registered at 1637 ADMIRAL TAUSSIG BLVD, NORFOLK, VA 235112803 (Tel: 7579539000)

πŸ“
Business Mailing Address (Initial Record) October 23, 2018

Registered at 145 GRANBY ST APT 505, NORFOLK, VA 235101660 (Tel: 7032548008)

πŸ‘€
Provider Name / Credentials (Initial Record) October 23, 2018

Recorded as JAE PARK

πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) October 23, 2018

Dentist (license number reported to NPPES: VA 0401416211)

🟒
Initial NPI Registration & Enumeration October 23, 2018

First registered as active Individual Practitioner in NPPES Database.

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NPI Administrative Meta

NPI Number: 1386110781
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: October 23, 2018
Last Update: February 28, 2023
Sole Proprietor: No

Mailing Address

2701 Neabsco Common Pl Apt 519

Woodbridge, VA 221916717

Phone: 7032548008

About This Data NPPES fields (address, phone, specialty, license) are self-reported and may be outdated; Medicare fields follow the CMS dataset named in each section. Correct directly at NPPES.