Individual provider Active NPI

William S Kim, D.D.S.

  • Oral and Maxillofacial Surgery (Dentist)
  • Shelby Township, MI
National Provider Identifier
1164815759
Registry record updated Mar 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
2901600783 Issued in MI
Practice address
51685 Van Dyke Ave
Shelby Township, MI 48316-4449
Phone
(586) 924-2038
Fax
(586) 323-1644
NPI assigned
Mar 6, 2015
Last updated
Mar 12, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 12, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist) 1223S0112X 2901600783 MI Primary

Addresses

Primary practice location

51685 Van Dyke Ave
Shelby Township, MI 48316-4449

Mailing address

51685 Van Dyke Ave
Shelby Township, MI 48316-4449
Phone (586) 924-2038

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231227002338 MI Practitioner - Maxillofacial SurgeryPractitioner - Oral Surgery 6608165089 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Maxillofacial SurgeryAlso: Oral Surgery
Education
Univ of Calif, San Francisco School of Dentistry, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Alamat Oral and Maxillofacial Surgery PLLCGroup PAC ID 4789959776, 2 clinicians

Practice addresses (Care Compare)

51685 Van Dyke Ave
Shelby Township, MI 48316-4449
Phone (586) 924-2038

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2901600783MIMDOral and Maxillofacial Surgery (Dentist)

Practice roles

OrganizationSpecialtyStatusNew patients
Alamat Oral & Maxillofacial Surgery PLLC Oral and Maxillofacial Surgery CurrentSince Nov 19, 2023 Accepting new patients

Locations

51685 Van Dyke Ave
Shelby Township, MI 48316
Phone (586) 924-2038

Interoperability endpoints

  • Direct secure messaging: wkim1134696@direct.hfhs.org

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1425600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741737600000",
    "number": "1164815759",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "51685 VAN DYKE AVE",
            "city": "SHELBY TOWNSHIP",
            "state": "MI",
            "postal_code": "483164449",
            "telephone_number": "586-924-2038",
            "fax_number": "586-323-1644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "51685 VAN DYKE AVE",
            "city": "SHELBY TOWNSHIP",
            "state": "MI",
            "postal_code": "483164449",
            "telephone_number": "586-924-2038",
            "fax_number": "586-323-1644"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "WILLIAM",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-03-06",
        "last_updated": "2025-03-12",
        "certification_date": "2025-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "MI",
            "license": "2901600783",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shelby Township, MI

Sources for this page

Verify at the official NPI Registry.