Active NPI
Hyeongil Kim, D.D.S.
- Prosthodontics
- Buffalo, NY
National Provider Identifier
1285869719
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Prosthodontics
- License
- 054804-1
- Practice address
- 3435 Main St.
Squire Hall, Room 210a
Buffalo, NY 14214-8006 - Phone
- (716) 829-2721
- Fax
- (716) 829-2031
- NPI assigned
- May 28, 2009
- 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 |
|---|---|---|---|---|
| Prosthodontics | 1223P0700X | 054804-1 | NY | Primary |
Addresses
Primary practice location
3435 Main St.
Squire Hall, Room 210a
Buffalo, NY 14214-8006
Mailing address
3435 Main St.
Squire Hall, Room 210a
Buffalo, NY 14214-8006
Phone (716) 829-2721
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 054804-1 | NY | MD | Prosthodontist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1243468800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1267401600000",
"number": "1285869719",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3435 MAIN ST.",
"address_2": "SQUIRE HALL, ROOM 210A",
"city": "BUFFALO",
"state": "NY",
"postal_code": "142148006",
"telephone_number": "716-829-2721",
"fax_number": "716-829-2031"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3435 MAIN ST.",
"address_2": "SQUIRE HALL, ROOM 210A",
"city": "BUFFALO",
"state": "NY",
"postal_code": "142148006",
"telephone_number": "716-829-2721",
"fax_number": "716-829-2031"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIM",
"first_name": "HYEONGIL",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2009-05-28",
"last_updated": "2010-03-01",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0700X",
"taxonomy_group": "",
"desc": "Dentist, Prosthodontics",
"state": "NY",
"license": "054804-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Buffalo, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.