Jin Heun Kim

Primary specialty

DentistTaxonomy code 122300000X

License

33320 Issued in TX

Practice address

2402 19TH St
Lubbock, TX 79401-4414

Phone

(888) 988-4066

Fax

(888) 988-4066

NPI assigned

Jul 20, 2017

Sex

Male

Sole proprietor

No

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)

Enrolled

Practice roles

Networks

• LA PPO C-SNP

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.

• Familia Dental Lubbock PLLC

  • Dental Clinic/Center
  • Lubbock, TX
  • NPI 1902126774
  NPD (past)

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

{
    "created_epoch": "1500508800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1500508800000",
    "number": "1063935112",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2050 E ALGONQUIN RD STE 610",
            "city": "SCHAUMBURG",
            "state": "IL",
            "postal_code": "601734166",
            "telephone_number": "888-988-4066"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2402 19TH ST",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794014414",
            "telephone_number": "888-988-4066",
            "fax_number": "888-988-4066"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "JIN",
        "middle_name": "HEUN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-07-20",
        "last_updated": "2017-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TX",
            "license": "33320",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kim E Pershall MD PA
• Nayeon Kim Thiesse, MD
• Charles Kim, D.O.
• Hyun Ah Kim
• Jeong Han Kim, PH.D., CRC
• Jongyeol Kim, MD
• Kevin Kim, PHARMD
• Nicole Kim, D.M.D., M.S.D.
• Samuel Kim, MD
• Sarah Ann Long Kim, PHD, LPC-S

• Dentist in Lubbock, TX
• Providers in Lubbock, TX by specialty
• Dentist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2017; 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.