Sung Hyon Kong, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

12010747A Issued in IN

Practice address

11530 Allisonville Rd
Suite 175
Fishers, IN 46038-1865

Phone

(317) 845-5100

Fax

(317) 845-5200

NPI assigned

Apr 9, 2007

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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in IN

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

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.

• Bright Smile Dental Care

  • Dentist
  • Fishers, IN
  • NPI 1003213646
  NPD (past) Authorized official

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

{
    "created_epoch": "1176076800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1210291200000",
    "number": "1063535698",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11530 ALLISONVILLE RD",
            "address_2": "SUITE 175",
            "city": "FISHERS",
            "state": "IN",
            "postal_code": "460381865",
            "telephone_number": "317-845-5100",
            "fax_number": "317-845-5200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11530 ALLISONVILLE RD",
            "address_2": "SUITE 175",
            "city": "FISHERS",
            "state": "IN",
            "postal_code": "460381865",
            "telephone_number": "317-845-5100",
            "fax_number": "317-845-5200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KONG",
        "first_name": "SUNG",
        "middle_name": "HYON",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-09",
        "last_updated": "2008-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IN",
            "license": "12010747A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200533220",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Heather Koenig, RVS, CCC
• Jena Renee Koenig
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• Konduiit Care System LLC
• Julie Nelson Korte, M.A.,CCC-SLP
• Stephanie N Korte, PA-C
• Aiden Kosegi
• Joe George Koselleck, ATC
• Bradley Kovert

• Dentist in Fishers, IN
• Providers in Fishers, IN by specialty
• Dentist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2008; 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.