Juhan Kim, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

040687 Issued in NY

Practice address

15017 Roosevelt Ave
Flushing, NY 11354

Phone

(718) 661-4052

Fax

(718) 661-4052

NPI assigned

Sep 26, 2006

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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1159228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1497856744",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15017 ROOSEVELT AVE",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "11354",
            "telephone_number": "718-661-4052",
            "fax_number": "718-661-4052"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15017 ROOSEVELT AVE",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "11354",
            "telephone_number": "718-661-4052",
            "fax_number": "718-661-4052"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "JUHAN",
        "name_prefix": "Mr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "040687",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01007363",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jong-Min Jonathon Kim, PHARMD
• Jongho Kim, DMD LAC PHD
• Joon Lae Kim, LIC.A
• Joonhyuk Kim, MD
• Joshua Seokju Kim
• Julia Kim, LMSW
• Jung Houn Kim, MD
• Jung Tak Kim
• Junhyung Nicolas Kim, NP
• Junsook Kim

• Dentist in Flushing, NY
• Providers in Flushing, NY by specialty
• Dentist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.