Scott Seung Young Kim, DMD, MD

Primary specialty

Oral & Maxillofacial Surgery (D.M.D.)Taxonomy code 204E00000X

License

16712 Issued in MD

Practice address

14333 Laurel Bowie Rd Ste 205
Laurel, MD 20708-1179

Phone

(301) 953-1888

NPI assigned

May 22, 2013

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in CT

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: scott.kim@xdr.hhchealthdirect.org

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Maryland Oral Surgery Associates, LLC

  • Oral and Maxillofacial Surgery (Dentist)
  • Rockville, MD
  • NPI 1326159179
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1369180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622073600000",
    "number": "1043656655",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6201 GREENBELT RD STE M1",
            "city": "COLLEGE PARK",
            "state": "MD",
            "postal_code": "207402358"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14333 LAUREL BOWIE RD STE 205",
            "city": "LAUREL",
            "state": "MD",
            "postal_code": "207081179",
            "telephone_number": "301-953-1888"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "263 Farmington Ave",
            "address_purpose": "LOCATION",
            "city": "Farmington",
            "state": "CT",
            "postal_code": "060321956",
            "country_code": "US",
            "telephone_number": "860-679-2839",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6201 Greenbelt Rd Ste M1",
            "address_purpose": "LOCATION",
            "city": "College Park",
            "state": "MD",
            "postal_code": "207402358",
            "country_code": "US",
            "telephone_number": "301-345-7007",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KIM",
        "first_name": "SCOTT",
        "middle_name": "SEUNG YOUNG",
        "credential": "DMD, MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-05-22",
        "last_updated": "2021-05-27",
        "certification_date": "2021-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "204E00000X",
            "taxonomy_group": "",
            "desc": "Oral & Maxillofacial Surgery",
            "state": "MD",
            "license": "16712",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sharareh Khanjani
• Elke Rifuh Khen
• Nadia Khoury, DPT
• Da Rye Kim, L.AC
• John Nyun Kim, DDS
• Sung Joo Kim, D.M.D
• Theodore Y Kim, M.D.
• Symphorian Mbunwe Kimbi, HHA
• Darla Kimbrough-Glears, SLP
• Michael Hunter Kime, DPT

• Oral & Maxillofacial Surgery (D.M.D.) in Laurel, MD
• Providers in Laurel, MD by specialty
• Oral & Maxillofacial Surgery (D.M.D.) in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.