Active NPI
Hanna Hyun Kim, DDS
- Dentist
- New York, NY
National Provider Identifier
1508333089
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 062176
- Practice address
- 225 Broadway
New York, NY 10007-3001 - Phone
- (212) 732-7400
- NPI assigned
- Nov 1, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Dentist | 122300000X | 062176 | NY | Primary |
Addresses
Primary practice location
225 Broadway
New York, NY 10007-3001
Mailing address
1901 1St Ave
New York, NY 10029-7491
Phone (212) 423-6271
Other practice location 1
1901 1st Ave
New York, NY 10029-7494
Phone (617) 314-5335
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
- 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 |
|---|---|---|---|---|
| I20240110002067 | NY | Practitioner - Oral Surgery | 8729439104 | Reassigns benefits to 5 organizations |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Bonita Sonrisa Dental Ipa | Current | Accepting new patients | |
| 3545 Johnson Blvd Dental PC | Current | Accepting new patients | |
| Spore Test Inc | Dentist | Current | Accepting new patients |
| Bonita Sonrisa Dental Mso | Current | Accepting new patients | |
| Alejandro Williams Dental Office PC | Current | Accepting new patients | |
| 43 Chruch Street Dental PC | Current | Accepting new patients |
Locations
759 4th Ave
Brooklyn, NY 11232
Phone (718) 832-1194
436 Fort Washington Ave
Apt 1B
New York, NY 10033
Phone (212) 923-6280
Organizations & group practices 6
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Dentist
- Bronx, NY
- NPI 1902533342
-
- Public Health Dentistry
- Bronx, NY
- NPI 1700343233
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1541030400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1689552000000",
"number": "1508333089",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1901 1ST AVE",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100297491",
"telephone_number": "212-423-6271"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "225 BROADWAY",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100073001",
"telephone_number": "212-732-7400"
}
],
"practiceLocations": [
{
"address_1": "1901 1st Ave",
"address_purpose": "LOCATION",
"city": "New York",
"state": "NY",
"postal_code": "100297494",
"country_code": "US",
"telephone_number": "617-314-5335",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "KIM",
"first_name": "HANNA",
"middle_name": "HYUN",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-11-01",
"last_updated": "2023-07-17",
"certification_date": "2023-07-17",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "NY",
"license": "062176",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in New York, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 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.