Sung-Oh Kim, DMD

Primary specialty

ProsthodonticsTaxonomy code 1223P0700X

License

DN013623 Issued in GA

Practice address

3651 Peachtree Pkwy Ste L
Suwanee, GA 30024-1089

Phone

(770) 622-2231

NPI assigned

May 22, 2008

Last updated

Jul 26, 2021By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1211414400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627257600000",
    "number": "1053578369",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3651 PEACHTREE PKWY STE L",
            "city": "SUWANEE",
            "state": "GA",
            "postal_code": "300241089",
            "telephone_number": "770-622-2231",
            "fax_number": "770-255-1615"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3651 PEACHTREE PKWY STE L",
            "city": "SUWANEE",
            "state": "GA",
            "postal_code": "300241089",
            "telephone_number": "770-622-2231"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "SUNG-OH",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-05-22",
        "last_updated": "2021-07-26",
        "certification_date": "2021-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "AL",
            "license": "5404",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "GA",
            "license": "DN013623",
            "primary": false
        },
        {
            "code": "1223P0700X",
            "taxonomy_group": "",
            "desc": "Dentist, Prosthodontics",
            "state": "GA",
            "license": "DN013623",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Min Tae Kim, DDS
• Rachel Kim, RBT
• Sehee Jenny Kim, D.M.D.
• Sejong Kim, PT
• Soon Ae Kim, D.C., L. AC.
• Taehyung Kim, MM, MT-BC
• Tomeka Park Kim, PHARM.D.
• Wan Kim
• William Kim, O.D.
• Kinetic Heart PT LLC

• Prosthodontics in Suwanee, GA
• Providers in Suwanee, GA by specialty
• Prosthodontics in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2021; 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.