Tae-Sok Kong, DDS

Primary specialty

EndodonticsTaxonomy code 1223E0200X

License

021.002274 Issued in IL

Practice address

7600 W College Dr
Palos Heights, IL 60463-1001

Phone

(708) 361-1770

NPI assigned

Aug 24, 2008

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 4

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": "1219536000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1219536000000",
    "number": "1144477902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7600 W COLLEGE DR",
            "city": "PALOS HEIGHTS",
            "state": "IL",
            "postal_code": "604631001",
            "telephone_number": "708-361-1770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7600 W COLLEGE DR",
            "city": "PALOS HEIGHTS",
            "state": "IL",
            "postal_code": "604631001",
            "telephone_number": "708-361-1770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KONG",
        "first_name": "TAE-SOK",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-08-24",
        "last_updated": "2008-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "IL",
            "license": "021.002274",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019.027600",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MO",
            "license": "2005015642",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NE",
            "license": "6602",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alexander Wolodymyr Kmicikewycz, MD
• Caitlin Marie Knight, LCPC
• Patrick M Knight, MSW
• Desire H Knox
• Matthew Scott Kominsky, MD
• Kevin E Konstant, DMD
• Natalie Korolis, DMD
• Joshua Koshiol, LPC
• William Kosmala, M.D.
• Adam Michael Kost, MD

• Endodontics in Palos Heights, IL
• Providers in Palos Heights, IL by specialty
• Endodontics in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2008; 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.