Daniel Y Kim, D.D.S.

Primary specialty

DentistTaxonomy code 122300000X

License

019020580 Issued in IL

Practice address

3434 W Peterson Ave Ste 204
Chicago, IL 60659-3300

Phone

(773) 588-3434

Fax

(773) 478-5406

NPI assigned

Jun 18, 2009

Last updated

Mar 17, 2016By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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 IL

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Northwest Implant Dental Spa

  • Dentist
  • Wheeling, IL
  • NPI 1922548270
  NPD (past) Authorized official

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

{
    "created_epoch": "1245283200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1458172800000",
    "number": "1457588378",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "109 N MILWAUKEE AVE",
            "city": "WHEELING",
            "state": "IL",
            "postal_code": "600903013",
            "telephone_number": "847-541-3434"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3434 W PETERSON AVE STE 204",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606593300",
            "telephone_number": "773-588-3434",
            "fax_number": "773-478-5406"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "DANIEL",
        "middle_name": "Y",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-06-18",
        "last_updated": "2016-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": "019020580",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dalton Robert Kim, MD PHD
• Dami Kim
• Daniel Kim, MD
• Daniel Kim, APRN, CNP
• Daniel Kim, MA
• David Kim
• David Dong Jin Kim
• David H Kim, PHARMD
• David Sungjin Kim, M.D.
• DO Young Kim, MD

• Dentist in Chicago, IL
• Providers in Chicago, IL by specialty
• Dentist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 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.