Individual provider Active NPI

Wook S Kim, DDS

  • General Practice Dentistry
  • Orland Park, IL
National Provider Identifier
1386828663
Registry record updated Dec 22, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Practice address
15856 Wolf Rd
Orland Park, IL 60467-4546
Phone
(708) 460-6666
Fax
(708) 460-6673
NPI assigned
Dec 22, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 22, 2007

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 IL Primary

Addresses

Primary practice location

15856 Wolf Rd
Orland Park, IL 60467-4546

Mailing address

15856 Wolf Rd
Orland Park, IL 60467-4546
Phone (708) 460-6666

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
019-025563ILMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1198281600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1198281600000",
    "number": "1386828663",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15856 WOLF RD",
            "city": "ORLAND PARK",
            "state": "IL",
            "postal_code": "604674546",
            "telephone_number": "708-460-6666",
            "fax_number": "708-460-6673"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15856 WOLF RD",
            "city": "ORLAND PARK",
            "state": "IL",
            "postal_code": "604674546",
            "telephone_number": "708-460-6666",
            "fax_number": "708-460-6673"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "WOOK",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-12-22",
        "last_updated": "2007-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orland Park, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2007; 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.