Daniel Yeil Kim, D.M.D.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

1001602-15 Issued in WI

Practice address

5201 Washington Ave Ste a
Racine, WI 53406-4242

Phone

(512) 297-6158

NPI assigned

Dec 3, 2016

Last updated

Mar 7, 2023By 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

Other identifiers 4

Other names 1

• Yeil Kim Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1480723200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1225571656",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5201 WASHINGTON AVE. SUITE A",
            "city": "RACINE",
            "state": "WI",
            "postal_code": "534064242",
            "telephone_number": "512-297-6158"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5201 WASHINGTON AVE STE A",
            "city": "RACINE",
            "state": "WI",
            "postal_code": "534064242",
            "telephone_number": "512-297-6158"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "DANIEL",
        "middle_name": "YEIL",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-12-03",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": "019030664",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WI",
            "license": "1001602-15",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OFFICE NPI",
            "identifier": "1962883926",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ILLINOIS DEPARTMENT OF FINANCIAL AND PROFESSIONAL REGULATION",
            "identifier": "019030664",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ILLINOIS DEPARTMENT OF FINANCIAL AND PROFESSIONAL REGULATION",
            "identifier": "319019971",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WISCONSIN DEPARTMENT OF SAFETY AND PROFESSIONAL SERVICES",
            "identifier": "100160215",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "YEIL",
            "last_name": "KIM",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Kenosha Community Health Center, Inc.
• Adel Khdour, MD
• Abigail Kibler
• Cynthia Ann Kickland
• Janet E. Kieslich, N.P.
• Robert B.H. Kim, MD MBA
• Debra Candy Kimaiga, LCSW, LPC, ICS
• Kind Dentistry LLC
• Kimberly A Kind-Bauer, DDS
• Nathalie Anne King, PA

• General Practice Dentistry in Racine, WI
• Providers in Racine, WI by specialty
• General Practice Dentistry in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.