Moo Hyun Kim, DDS

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

10490 Issued in TN

Practice address

2711 Medical Center Pkwy
Murfreesboro, TN 37129-3724

Phone

(615) 617-6191

NPI assigned

May 6, 2016

Sex

Male

Sole proprietor

No

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

Specialties & licenses 6

Addresses

Medicare fee-for-service enrollment

Enrolled in CO

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.

• McKenzie Oral and Facial Surgery PLLC

  • Oral and Maxillofacial Surgery (Dentist)
  • Dickson, TN
  • NPI 1922568666
  NPD (past)
• Santa Fe Modern Dentistry and Orthodontics, LLC

  dba Santa Fe Modern Dentistry and Orthodontics

  • General Practice Dentistry
  • Santa Fe, NM
  • NPI 1689950008
  NPD (past)

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

{
    "created_epoch": "1462492800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690156800000",
    "number": "1508212770",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2711 MEDICAL CENTER PKWY",
            "city": "MURFREESBORO",
            "state": "TN",
            "postal_code": "371293724"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2711 MEDICAL CENTER PKWY",
            "city": "MURFREESBORO",
            "state": "TN",
            "postal_code": "371293724",
            "telephone_number": "615-617-6191"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "531 Elm St",
            "address_purpose": "LOCATION",
            "city": "New Haven",
            "state": "CT",
            "postal_code": "065114549",
            "country_code": "US",
            "telephone_number": "203-901-1323",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1888 Main St",
            "address_purpose": "LOCATION",
            "city": "Hartford",
            "state": "CT",
            "postal_code": "061202357",
            "country_code": "US",
            "telephone_number": "860-768-9062",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3227 W Blue Ridge Dr",
            "address_purpose": "LOCATION",
            "city": "Greenville",
            "state": "SC",
            "postal_code": "296113905",
            "country_code": "US",
            "telephone_number": "864-332-4778",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1301 Winchester Rd Ste 225",
            "address_purpose": "LOCATION",
            "city": "Lexington",
            "state": "KY",
            "postal_code": "405054132",
            "country_code": "US",
            "telephone_number": "859-226-0679",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "105 Myrtle St",
            "address_purpose": "LOCATION",
            "city": "New Britain",
            "state": "CT",
            "postal_code": "060511859",
            "country_code": "US",
            "telephone_number": "860-356-4546",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "738 Wolcott St",
            "address_purpose": "LOCATION",
            "city": "Waterbury",
            "state": "CT",
            "postal_code": "067051336",
            "country_code": "US",
            "telephone_number": "203-437-6213",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "144 Boston Ave",
            "address_purpose": "LOCATION",
            "city": "Bridgeport",
            "state": "CT",
            "postal_code": "066101604",
            "country_code": "US",
            "telephone_number": "203-437-7561",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "324 22nd Ave N",
            "address_purpose": "LOCATION",
            "city": "Nashville",
            "state": "TN",
            "postal_code": "37203",
            "country_code": "US",
            "telephone_number": "615-329-4401",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8210 Floyd Curl Drive, MC 8214",
            "address_purpose": "LOCATION",
            "city": "San Antonio",
            "state": "Texas",
            "postal_code": "78229",
            "country_code": "UM",
            "telephone_number": "210-450-3134",
            "country_name": "United States Minor Outlying Islands",
            "address_type": "FGN"
        },
        {
            "address_1": "3569 Zafarano Dr",
            "address_purpose": "LOCATION",
            "city": "Santa Fe",
            "state": "NM",
            "postal_code": "875072618",
            "country_code": "US",
            "telephone_number": "505-986-8000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KIM",
        "first_name": "MOO HYUN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-05-06",
        "last_updated": "2023-07-24",
        "certification_date": "2023-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CT",
            "license": "12149",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "KY",
            "license": "10206",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "SC",
            "license": "9287",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "NM",
            "license": "DB-2023-0206",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "TN",
            "license": null,
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "TN",
            "license": "10490",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jasey Kilgore
• Julia Alexandra Kilgore
• Melissa Kilpatrick, LADAC II, ADS
• Kim P Scott MD, LLC
• Melanie Arang Kim-Park, DDS, MS
• Darbra Willis Kimbel, NP-C
• Geoffrey H Kimber II, PHARMD
• Kimberly Dryden Pitts DDS PC
• Lori Ann Kimble, LPN
• Sydney Kimmel

• Oral and Maxillofacial Surgery (Dentist) in Murfreesboro, TN
• Providers in Murfreesboro, TN by specialty
• Oral and Maxillofacial Surgery (Dentist) in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2023; 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.