Taylor Yong Kim, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D5028 Issued in AZ

Practice address

2080 W Southern Ave
A-3
Apache Junction, AZ 85120-7455

Phone

(480) 288-2003

Fax

(480) 288-2048

NPI assigned

Oct 3, 2006

Last updated

Feb 9, 2016By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AZ

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

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1454976000000",
    "number": "1558456186",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2080 W SOUTHERN AVE",
            "address_2": "A-3",
            "city": "APACHE JUNCTION",
            "state": "AZ",
            "postal_code": "851207455",
            "telephone_number": "480-288-2003",
            "fax_number": "480-288-2048"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2080 W SOUTHERN AVE",
            "address_2": "A-3",
            "city": "APACHE JUNCTION",
            "state": "AZ",
            "postal_code": "851207455",
            "telephone_number": "480-288-2003",
            "fax_number": "480-288-2048"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "TAYLOR",
        "middle_name": "YONG",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-03",
        "last_updated": "2016-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AZ",
            "license": "D5028",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rickey D Keller, DC
• Kyle Kelly, PHARM, D.
• Patricia K Kennedy, NP
• Roger M. Kern
• Deanna Kiester, LAC
• Kinder Pediatric Dental Specialist, PLLC
• Cecile Carol-Ann King, M.D.
• Jean-Paul A. Kingsley, LCSW
• Karen Sue Kittle, OTR
• Klitzke Family Chiropractic & Rehab, LLC (Apache Gold Chiropractic)

• General Practice Dentistry in Apache Junction, AZ
• Providers in Apache Junction, AZ by specialty
• General Practice Dentistry in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 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.

Verify at the official NPI Registry.