Shawn Seonghoon Kim, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DN1856147 Issued in MA

Practice address

1138 River St
Hyde Park, MA 02136-2970

Phone

(213) 700-9838

NPI assigned

Aug 22, 2011

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MA

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

State licenses

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.

• Ace Dental Cambridge PLLC

  • Dental Clinic/Center
  • Cambridge, MA
  • NPI 1336998525
  NPD Authorized official
• Ace Dental Central Square, PLLC

  • Dental Clinic/Center
  • Cambridge, MA
  • NPI 1033006846
  NPD Authorized official
• Ace Dental West Roxbury, PLLC

  • Dental Clinic/Center
  • West Roxbury, MA
  • NPI 1679225114
  NPD Authorized official

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

{
    "created_epoch": "1313971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1472774400000",
    "number": "1316227499",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1138 RIVER ST",
            "city": "HYDE PARK",
            "state": "MA",
            "postal_code": "02136",
            "telephone_number": "213-700-9838"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1138 RIVER ST",
            "city": "HYDE PARK",
            "state": "MA",
            "postal_code": "021362970",
            "telephone_number": "213-700-9838"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "SHAWN",
        "middle_name": "SEONGHOON",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-08-22",
        "last_updated": "2016-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MA",
            "license": "DN1856147",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nicole S Katz
• Ravi Kavasery, M.D.
• Keka Services, Inc
• David Paul Kennedy
• Lily Keohane
• King Capital Inc
• Maria King-Bynoe
• Maria G Knight
• Inna O Komarovskaya, D.M.D.
• Heather Kough

• General Practice Dentistry in Hyde Park, MA
• Providers in Hyde Park, MA by specialty
• General Practice Dentistry in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2016; 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.