Soonki Kim, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

23100 Issued in TX

Practice address

2216 Royal LN Ste 115
Dallas, TX 75229-7827

Phone

(972) 243-0365

Fax

(972) 247-0898

NPI assigned

Apr 7, 2007

Last updated

Sep 29, 2020By the provider in NPPES

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 TX

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

Practice roles

Locations

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.

• Dr. Kim's Dental, Inc

  • General Practice Dentistry
  • Dallas, TX
  • NPI 1649593971
  Medicare reassignment NPD Authorized official
• Nexden LLC

  • Dental Clinic/Center
  • Plano, TX
  • NPI 1740995208
  NPD

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

{
    "created_epoch": "1175904000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601337600000",
    "number": "1225151186",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2216 ROYAL LN STE 115",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752297827",
            "telephone_number": "972-243-0365",
            "fax_number": "972-247-0898"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2216 ROYAL LN STE 115",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752297827",
            "telephone_number": "972-243-0365",
            "fax_number": "972-247-0898"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "SOONKI",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-07",
        "last_updated": "2020-09-29",
        "certification_date": "2020-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TX",
            "license": "23100",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "23100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sara Eunah Kim
• SE-in Kim, M. A. CCC-SLP
• Sebyuk Chloe Kim, DMD
• Seung Kwon Kim, MD
• So Yeon Kim, MD
• Stella Hyesook Kim, DNAP
• Stephanie Kim
• Sunghyun Kim, DC
• Susan Emily Kim, DDS
• Tae Kun Kim, D.C.

• General Practice Dentistry in Dallas, TX
• Providers in Dallas, 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 29, 2020; 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.