John Minwoo Kum, DDS, MS

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

1636 Issued in WY

Practice address

1401 Airport Pkwy Ste 110
Cheyenne, WY 82001-1522

Phone

(307) 632-4574

NPI assigned

Sep 29, 2017

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

Practice roles

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.

• Cheyenne Periodontics, PC

  • Periodontics
  • Cheyenne, WY
  • NPI 1326127234
  NPD (past)

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

{
    "created_epoch": "1506643200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712275200000",
    "number": "1043729304",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1401 AIRPORT PKWY STE 110",
            "city": "CHEYENNE",
            "state": "WY",
            "postal_code": "820011522",
            "telephone_number": "307-632-4574"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 AIRPORT PKWY STE 110",
            "city": "CHEYENNE",
            "state": "WY",
            "postal_code": "820011522",
            "telephone_number": "307-632-4574"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUM",
        "first_name": "JOHN",
        "middle_name": "MINWOO",
        "name_prefix": "Dr.",
        "credential": "DDS, MS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-09-29",
        "last_updated": "2024-04-05",
        "certification_date": "2024-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Periodontics",
            "state": "WY",
            "license": "1636",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mary Charlotte Krul
• Kimberly Krumm
• Samer Ksaibati, RN
• Michael Pete Kuhn, M.D.
• Brenda Ann Kulju, PSYCHIATRIC NP
• Shatra' Kurtz
• Candi Kusler, PPC
• Jason Kutsulis
• Pazleigh Kvarnstrom
• KW Therapy, LLC

• Periodontics in Cheyenne, WY
• Providers in Cheyenne, WY by specialty
• Periodontics in Wyoming

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.