Active NPI
Jun Oh Kim, D.D.S
- General Practice Dentistry
- Forest Hills, NY
National Provider Identifier
1285072298
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 057338
- Practice address
- 10737 71St Ave Ste 4
Forest Hills, NY 11375 - Phone
- (516) 987-0036
- NPI assigned
- Jun 12, 2013
- 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 | 057338 | NY | Primary |
Addresses
Primary practice location
10737 71St Ave Ste 4
Forest Hills, NY 11375
Mailing address
4543 216TH St
Bayside, NY 11361-3450
Phone (516) 987-0036
Other practice location 1
2 Rubin Dr
Rushville, NY 14544-9681
Phone (585) 554-4400
Other practice location 2
2 Rubin Dr
Rushville, NY 14544
Phone (585) 554-4400
Other practice location 3
2 Rubin Dr
Rushville, NY 14544
Phone (585) 554-4400
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150702001346 | NY | Order and Referring Only - Dentist | 8426360561 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1370995200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1549756800000",
"number": "1285072298",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4543 216TH ST",
"city": "BAYSIDE",
"state": "NY",
"postal_code": "113613450",
"telephone_number": "516-987-0036"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10737 71ST AVE STE 4",
"city": "FOREST HILLS",
"state": "NY",
"postal_code": "11375",
"telephone_number": "516-987-0036"
}
],
"practiceLocations": [
{
"address_1": "2 Rubin Dr",
"address_purpose": "LOCATION",
"city": "Rushville",
"state": "NY",
"postal_code": "145449681",
"country_code": "US",
"telephone_number": "585-554-4400",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "2 Rubin Dr",
"address_purpose": "LOCATION",
"city": "Rushville",
"state": "NY",
"postal_code": "14544",
"country_code": "US",
"telephone_number": "585-554-4400",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "2 Rubin Dr",
"address_purpose": "LOCATION",
"city": "Rushville",
"state": "NY",
"postal_code": "14544",
"country_code": "US",
"telephone_number": "585-554-4400",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "KIM",
"first_name": "JUN OH",
"name_prefix": "Dr.",
"credential": "D.D.S",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2013-06-12",
"last_updated": "2019-02-10",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "NY",
"license": "057338",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Forest Hills, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2019; 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.