Hyun Bok Kim, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DN012510 Issued in GA

Practice address

1160 Old Peachtree Rd
Ste B
Duluth, GA 30097

Phone

(678) 473-7770

Fax

(678) 473-1066

NPI assigned

May 22, 2007

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 names 1

• Zachary Kim Professional name

Medicare fee-for-service enrollment

Enrolled in GA

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

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

{
    "created_epoch": "1179792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1508075953",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1160 OLD PEACHTREE RD",
            "address_2": "STE B",
            "city": "DULUTH",
            "state": "GA",
            "postal_code": "30097",
            "telephone_number": "678-473-7770",
            "fax_number": "678-473-1066"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1160 OLD PEACHTREE RD",
            "address_2": "STE B",
            "city": "DULUTH",
            "state": "GA",
            "postal_code": "30097",
            "telephone_number": "678-473-7770",
            "fax_number": "678-473-1066"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "HYUN",
        "middle_name": "BOK",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-22",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "GA",
            "license": "DN012510",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ZACHARY",
            "last_name": "KIM",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Byung Yull Kim, D.C.
• Chang Soo Kim, MD
• Choon K. Kim, LDO
• Cristina Kim, LD, MPH
• Eunyoung Kim
• Hyunjung Kim
• Ji a Kim
• Jin Dea Kim, M.D.
• Jina Y. Kim, MD
• Jiyeon Kim, PA

• General Practice Dentistry in Duluth, GA
• Providers in Duluth, GA by specialty
• General Practice Dentistry in Georgia

• 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.
• 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.