Active NPI
Yong-Ha Kim, DDS
- General Practice Dentistry
- Medina, OH
National Provider Identifier
1497919229
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 30 022827
- Practice address
- 807 E Washington St
Suite 160
Medina, OH 44256-3338 - Phone
- (330) 722-4506
- NPI assigned
- Jul 10, 2008
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 30 022827 | OH | Primary |
Addresses
Primary practice location
807 E Washington St
Suite 160
Medina, OH 44256-3338
Mailing address
807 E Washington St
Suite 160
Medina, OH 44256-3338
Phone (330) 722-4506
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OH
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160224001461 | OH | Order and Referring Only - Dentist | 0941505218 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 30 022827 | OH | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1215648000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1465862400000",
"number": "1497919229",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "807 E WASHINGTON ST",
"address_2": "SUITE 160",
"city": "MEDINA",
"state": "OH",
"postal_code": "442563338",
"telephone_number": "330-722-4506"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "807 E WASHINGTON ST",
"address_2": "SUITE 160",
"city": "MEDINA",
"state": "OH",
"postal_code": "442563338",
"telephone_number": "330-722-4506"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIM",
"first_name": "YONG-HA",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-07-10",
"last_updated": "2016-06-14",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "OH",
"license": "30 022827",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Medina, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 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.