Heidi Hye Won Kim, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

8014 Issued in NV

Practice address

1820 E Craig Rd Ste 102
North Las Vegas, NV 89030-3321

Phone

(702) 680-1009

NPI assigned

Sep 6, 2024

Sex

Female

Sole proprietor

No

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 NV

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.

• Lee Craig Ranch Dental Group, PC

  • Dentist
  • Las Vegas, NV
  • NPI 1649793324
  NPD (past)

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

{
    "created_epoch": "1725580800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727827200000",
    "number": "1245065309",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 SHADOW LN",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891064124"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1820 E CRAIG RD STE 102",
            "city": "NORTH LAS VEGAS",
            "state": "NV",
            "postal_code": "890303321",
            "telephone_number": "702-680-1009"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1001 Shadow Ln",
            "address_purpose": "LOCATION",
            "city": "Las Vegas",
            "state": "NV",
            "postal_code": "891064124",
            "country_code": "US",
            "telephone_number": "702-774-2400",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KIM",
        "first_name": "HEIDI",
        "middle_name": "HYE WON",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-09-06",
        "last_updated": "2024-10-02",
        "certification_date": "2024-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NV",
            "license": "8014",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kim Happy Dental DMD PLLC
• Daniel H Kim, DO
• David C Kim, PHARMD
• Dong-Kyu Kim, DMD
• Eng Kim
• Howard Kim, DPT
• Hyo Ju Kim, PHARMD
• Hyunsoo Kim
• Joanna Kim, O.D.
• Jun Chong Kim, DO

• Dentist in North Las Vegas, NV
• Providers in North Las Vegas, NV by specialty
• Dentist in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2024; 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.