Active NPI
Yeong W Kim, D.D.S
- General Practice Dentistry
- Las Vegas, NV
National Provider Identifier
1184705824
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 4280
- Practice address
- 6002 S Durango Dr
Suite 100
Las Vegas, NV 89113-1785 - Phone
- (775) 453-0287
- NPI assigned
- Oct 18, 2006
- Sex
- Male
- Sole proprietor
- No
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 | 4280 | NV | Primary |
Addresses
Primary practice location
6002 S Durango Dr
Suite 100
Las Vegas, NV 89113-1785
Mailing address
6002 S Durango Dr
Suite 100
Las Vegas, NV 89113-1785
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4280 | NV | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161129600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1442188800000",
"number": "1184705824",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6002 S DURANGO DR",
"address_2": "SUITE 100",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "891131785"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6002 S DURANGO DR",
"address_2": "SUITE 100",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "891131785",
"telephone_number": "775-453-0287"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIM",
"first_name": "YEONG",
"middle_name": "W",
"name_prefix": "Dr.",
"credential": "D.D.S",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-18",
"last_updated": "2015-09-14",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "NV",
"license": "4280",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Las Vegas, NV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.