Active NPI
Han Chu Kim, D.D.S., M.S., P.A.
- Periodontics
- Houston, TX
National Provider Identifier
1164404646
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Periodontics
- License
- 19503
- Practice address
- 4543 Post Oak Place
Ste 108
Houston, TX 77027-3160 - Phone
- (713) 629-5170
- Fax
- (713) 629-5172
- NPI assigned
- Nov 18, 2005
- Last updated
- Jul 8, 2007
- 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 |
|---|---|---|---|---|
| Periodontics | 1223P0300X | 19503 | TX | Primary |
Addresses
Primary practice location
4543 Post Oak Place
Ste 108
Houston, TX 77027-3160
Mailing address
4543 Post Oak Place Dr
Ste 108
Houston, TX 77027-3160
Phone (713) 629-5170
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
- Opted out of Medicare
- Yes, effective Mar 22, 2016 through Mar 22, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Science, Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 19503 | TX | MD | Periodontist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1132272000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1164404646",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4543 POST OAK PLACE DR",
"address_2": "STE 108",
"city": "HOUSTON",
"state": "TX",
"postal_code": "770273160",
"telephone_number": "713-629-5170",
"fax_number": "713-629-5172"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4543 POST OAK PLACE",
"address_2": "STE 108",
"city": "HOUSTON",
"state": "TX",
"postal_code": "770273160",
"telephone_number": "713-629-5170",
"fax_number": "713-629-5172"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIM",
"first_name": "HAN CHU",
"name_prefix": "Dr.",
"credential": "D.D.S., M.S., P.A.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-11-18",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0300X",
"taxonomy_group": "",
"desc": "Dentist, Periodontics",
"state": "TX",
"license": "19503",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Houston, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.