Active NPI
Yong Kim, D.D.S.
- General Practice Dentistry
- Melrose Park, IL
National Provider Identifier
1104052463
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 019.027940
- Practice address
- 2537 W North Ave
Melrose Park, IL 60160-1121 - Phone
- (847) 757-9664
- NPI assigned
- Jun 1, 2009
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 019.027940 | IL | Primary |
Addresses
Primary practice location
2537 W North Ave
Melrose Park, IL 60160-1121
Mailing address
430 W Erie St
Ste 200
Chicago, IL 60654-6914
Phone (920) 838-1649
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 019.027940 | IL | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Dental Experts, LLC | General Practice | Past | Accepting new patients |
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1243814400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1243814400000",
"number": "1104052463",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "430 W ERIE ST",
"address_2": "STE 200",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606546914",
"telephone_number": "920-838-1649"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2537 W NORTH AVE",
"city": "MELROSE PARK",
"state": "IL",
"postal_code": "601601121",
"telephone_number": "847-757-9664"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIM",
"first_name": "YONG",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2009-06-01",
"last_updated": "2009-06-01",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "IL",
"license": "019.027940",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Melrose Park, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.