Active NPI
Roy Jun Kim, D.M.D
- Dentist
- Buford, GA
National Provider Identifier
1306191051
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- DN124138
- Practice address
- 3420 Buford Dr Ste E780
Buford, GA 30519-8774 - Phone
- (770) 858-1678
- NPI assigned
- Jul 18, 2012
- Last updated
- Sep 18, 2026
- 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 |
|---|---|---|---|---|
| Dentist | 122300000X | DN124138 | GA | Primary |
Addresses
Primary practice location
3420 Buford Dr Ste E780
Buford, GA 30519-8774
Mailing address
3199 Thompson Mill Rd
Buford, GA 30519
Phone (714) 615-7869
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 |
|---|---|---|---|
| DN1856073 | MA | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Dental Dreams LLC | Past | Accepting new patients |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- General Practice Dentistry
- Springfield, MA
- NPI 1245407881
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1342569600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1789689600000",
"number": "1306191051",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3199 THOMPSON MILL RD",
"city": "BUFORD",
"state": "GA",
"postal_code": "30519",
"telephone_number": "714-615-7869"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3420 BUFORD DR STE E780",
"city": "BUFORD",
"state": "GA",
"postal_code": "305198774",
"telephone_number": "770-858-1678"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIM",
"first_name": "ROY",
"middle_name": "JUN",
"credential": "D.M.D",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2012-07-18",
"last_updated": "2026-09-18",
"certification_date": "2026-09-17",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "GA",
"license": "DN124138",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Buford, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.