Kyung Ha Kim, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

39218 Issued in TX

Practice address

3255 Shearwater LN
Flower Mound, TX 75028-5718

Phone

(858) 610-8988

NPI assigned

Oct 19, 2012

Sex

Female

Sole proprietor

No

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 TX

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 and National Provider Directory roles.

• Roanoke Dental Group,PC

  • Dentist
  • Roanoke, TX
  • NPI 1952760050
  NPD (past)
• J.Warren Hildreth, Jr., DDS PA

  • General Practice Dentistry
  • Saint Marys, KS
  • NPI 1962782680
  NPD (past)
• Sleep Better Kansas LLC

  • Customized Equipment (DME)
  • Wamego, KS
  • NPI 1275274276
  NPD (past)
• Wamego Dental Professionals LLC

  • Dental Clinic/Center
  • Wamego, KS
  • NPI 1477112563
  NPD (past)

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

{
    "created_epoch": "1350604800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730160000000",
    "number": "1659624252",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3255 SHEARWATER LN",
            "city": "FLOWER MOUND",
            "state": "TX",
            "postal_code": "750285718",
            "telephone_number": "858-610-8988"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3255 SHEARWATER LN",
            "city": "FLOWER MOUND",
            "state": "TX",
            "postal_code": "750285718",
            "telephone_number": "858-610-8988"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1320 N Highway 377 Ste 100",
            "address_purpose": "LOCATION",
            "city": "Roanoke",
            "state": "TX",
            "postal_code": "762629131",
            "country_code": "US",
            "telephone_number": "817-345-0695",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4351 Cross Timbers Rd Ste 100",
            "address_purpose": "LOCATION",
            "city": "Flower Mound",
            "state": "TX",
            "postal_code": "750283014",
            "country_code": "US",
            "telephone_number": "972-539-2820",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KIM",
        "first_name": "KYUNG HA",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-10-19",
        "last_updated": "2024-10-29",
        "certification_date": "2024-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "39218",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kathlyn Kight, MD
• Christopher Jinwoo Kim, DPT
• Jason Kim, LPC
• Jin Kim, D.C.
• Joseph M Kim, M.D.
• May Kim, M.D.
• Stephen Hojong Kim, D.D.S., M.S.
• Sunghee Kim
• Timothy Kim
• Justin L Kimble, MA, BCBA

• General Practice Dentistry in Flower Mound, TX
• Providers in Flower Mound, TX by specialty
• General Practice Dentistry in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2024; 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.