Sean Hyungbeom Kim

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

8716 Issued in CT

Practice address

115 Bridge St
Groton, CT 06340-3603

Phone

(860) 446-8744

Fax

(860) 448-3780

NPI assigned

Jun 4, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Dr. Sean Hyungbeom Kim Professional name

Medicare fee-for-service enrollment

Enrolled in CT

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

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Bridgeworks LLC

  • General Practice Dentistry
  • Groton, CT
  • NPI 1720034457
  NPD (past)

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

{
    "created_epoch": "1180915200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1444262400000",
    "number": "1225230998",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 BRIDGE ST",
            "city": "GROTON",
            "state": "CT",
            "postal_code": "063403603",
            "telephone_number": "860-446-8744",
            "fax_number": "860-448-3780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 BRIDGE ST",
            "city": "GROTON",
            "state": "CT",
            "postal_code": "063403603",
            "telephone_number": "860-446-8744",
            "fax_number": "860-448-3780"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "SEAN",
        "middle_name": "HYUNGBEOM",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-06-04",
        "last_updated": "2015-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CT",
            "license": "8716",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SEAN",
            "last_name": "KIM",
            "middle_name": "HYUNGBEOM",
            "prefix": "DR.",
            "credential": "DDS",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Leslie Kelly, RN
• Lajward Khan
• Mabroor A Khan, DMD
• Daniel Adam Kilhefner, SUBIDC
• Alexander John Kim, MD
• Jeremiah Loius King, IDC
• Marissa King
• Matthew John King
• Susan King, MSW
• Jennifer Sara Kinshaw

• General Practice Dentistry in Groton, CT
• Providers in Groton, CT by specialty
• General Practice Dentistry in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2015; 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.