Kobawoo Dental Center

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DS026455L Issued in PA

Legal business name

KOBAWOO DENTAL CENTER

Practice address

1222 Welsh Rd
Suite G
North Wales, PA 19454-2054

Phone

(215) 362-3000

Fax

(267) 263-1499

NPI assigned

Mar 24, 2016

Last updated

Mar 24, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. He-Kyung Kim-Yu, D.M.D.NPI 1396076196

Title

Dentist

Phone

(215) 362-3000

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• He-Kyung Kim-Yu, D.M.D.

  • General Practice Dentistry
  • North Wales, PA
  • NPI 1396076196
  NPD (past) Authorized official

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

{
    "created_epoch": "1458777600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1458777600000",
    "number": "1326400748",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1222 WELSH RD",
            "address_2": "SUITE G",
            "city": "NORTH WALES",
            "state": "PA",
            "postal_code": "194542054",
            "telephone_number": "215-362-3000",
            "fax_number": "267-263-1499"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1222 WELSH RD",
            "address_2": "SUITE G",
            "city": "NORTH WALES",
            "state": "PA",
            "postal_code": "194542054",
            "telephone_number": "215-362-3000",
            "fax_number": "267-263-1499"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KOBAWOO DENTAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-03-24",
        "last_updated": "2016-03-24",
        "status": "A",
        "authorized_official_last_name": "KIM-YU",
        "authorized_official_first_name": "HE-KYUNG",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "215-362-3000",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.M.D."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "PA",
            "license": "DS026455L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1026469620001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Justin Klaff, M.D.
• Ronald L Klein, DMD
• Robert C Kleiner, M.D.
• Alyssa Kleynen, CCC-SLP/L
• KNK Vision Corp (Sterling Optical)
• Kerry E Krauss, M.D.
• Chelsea Krawitz
• Donald E. Kraybill, PH.D.
• Thomas Alan Kriczky, D.O.
• Natalie Kwortnik, OT

• General Practice Dentistry in North Wales, PA
• Providers in North Wales, PA by specialty
• General Practice Dentistry in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2016; 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.