NPIMap

Individual provider Active NPI

Kyung Hyun Kim, DDS

  • General Practice Dentistry
  • Great Neck, NY
National Provider Identifier
1427157940
Registry record updated May 4, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
053232-1 Issued in NY
Practice address
1 Barstow Rd # P23
Great Neck, NY 11021-3501
Phone
(516) 466-8744
Fax
(516) 829-3650
NPI assigned
Sep 21, 2006
Last updated
May 4, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 4, 2018

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 5653015 WI
General Practice Dentistry 1223G0001X 053232 NY
General Practice Dentistry 1223G0001X 053232-1 NY Primary

Addresses

Primary practice location

1 Barstow Rd # P23
Great Neck, NY 11021-3501

Mailing address

1 Barstow Rd # P23
Great Neck, NY 11021-3501
Phone (516) 466-8744

Other identifiers 2

IdentifierTypeStateIssuer
02832768MedicaidNY
33782800MedicaidWI

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
5653015WIMDDentist
053232NYMDGeneral Practice Dentistry
053232-1NYMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
KVL Dental Group P.C. General Practice Past Accepting new patients
KHK Dentisrty PC Dentist Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1158796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1525392000000",
    "number": "1427157940",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 BARSTOW RD # P23",
            "city": "GREAT NECK",
            "state": "NY",
            "postal_code": "110213501",
            "telephone_number": "516-466-8744",
            "fax_number": "516-829-3650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 BARSTOW RD # P23",
            "city": "GREAT NECK",
            "state": "NY",
            "postal_code": "110213501",
            "telephone_number": "516-466-8744",
            "fax_number": "516-829-3650"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "KYUNG",
        "middle_name": "HYUN",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-21",
        "last_updated": "2018-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WI",
            "license": "5653015",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "053232",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "053232-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02832768",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "33782800",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Great Neck, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2018; 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.