Kyeong Hwan Kim, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

38829 Issued in TX

Practice address

5757 Warren Pkwy Ste 220
Frisco, TX 75034-4207

Phone

(567) 408-9815

NPI assigned

May 18, 2020

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in OH

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

State licenses

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

{
    "created_epoch": "1589760000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662422400000",
    "number": "1154943785",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4221 OLD DENTON RD APT 6201",
            "city": "CARROLLTON",
            "state": "TX",
            "postal_code": "750102332",
            "telephone_number": "567-408-9815"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5757 WARREN PKWY STE 220",
            "city": "FRISCO",
            "state": "TX",
            "postal_code": "750344207",
            "telephone_number": "567-408-9815"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4221 Old Denton Rd Apt 6201",
            "address_purpose": "LOCATION",
            "city": "Carrollton",
            "state": "TX",
            "postal_code": "750102332",
            "country_code": "US",
            "telephone_number": "567-408-9815",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KIM",
        "first_name": "KYEONG HWAN",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-05-18",
        "last_updated": "2022-09-06",
        "certification_date": "2022-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OH",
            "license": "30.026136",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "38829",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jonathan Kiev, MD
• Betty Chelagat Kigen, AGPCNP
• Leon Clancy Kilpatrick, LPC-S
• Dean Donghyun Kim, DPM
• Hong Kim
• Mee Ok Kim, D.C., FNP-C
• Nuri Kim, D.D.S.
• Si-on Kim, OD
• Stephen Alan Kim, M.D.
• Sun Ho Kim, DMD

• General Practice Dentistry in Frisco, TX
• Providers in Frisco, TX by specialty
• General Practice Dentistry in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2022; 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.