Individual provider Active NPI

Byung Yoon Kim, DDS

  • General Practice Dentistry
  • Winchester, VA
National Provider Identifier
1295300820
Registry record updated Jul 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
0401417518 Issued in VA
Practice address
633 Cedar Creek Grade
Winchester, VA 22601-2708
Phone
(540) 450-2100
NPI assigned
May 25, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 7, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 0401417518 VA Primary

Addresses

Primary practice location

633 Cedar Creek Grade
Winchester, VA 22601-2708

Mailing address

633 Cedar Creek Grade
Winchester, VA 22601-2708
Phone (540) 450-2100

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

LicenseStateTypeSpecialty
0401417518VAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Smiles of Virginia Family Dental Center, PLLC CurrentSince Jul 3, 2022 Accepting new patients

Locations

633 Cedar Creek Grade
Winchester, VA 22601
Phone (540) 450-2100

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1621900800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657152000000",
    "number": "1295300820",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "633 CEDAR CREEK GRADE",
            "city": "WINCHESTER",
            "state": "VA",
            "postal_code": "226012708",
            "telephone_number": "540-450-2100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "633 CEDAR CREEK GRADE",
            "city": "WINCHESTER",
            "state": "VA",
            "postal_code": "226012708",
            "telephone_number": "540-450-2100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "BYUNG YOON",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-05-25",
        "last_updated": "2022-07-07",
        "certification_date": "2022-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "VA",
            "license": "0401417518",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winchester, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2022; 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.