Active NPI
Jongguon Kim, DDS
- Dentist
- Anchorage, AK
National Provider Identifier
1659820728
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 115372
- Practice address
- 9138 Arlon St Ste B4
Anchorage, AK 99507-3876 - Phone
- (907) 333-6666
- NPI assigned
- Sep 29, 2016
- Last updated
- Sep 29, 2016
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 115372 | AK | Primary |
Addresses
Primary practice location
9138 Arlon St Ste B4
Anchorage, AK 99507-3876
Mailing address
7308 Chugach Meadows Loop
Anchorage, AK 99507-2685
Phone (909) 342-3009
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 115372 | AK | MD | Dentist |
Organizations & group practices 1
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.
-
dba Smarteeth Dental
- Dental Clinic/Center
- Corona, CA
- NPI 1861034944
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1475107200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1475107200000",
"number": "1659820728",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7308 CHUGACH MEADOWS LOOP",
"city": "ANCHORAGE",
"state": "AK",
"postal_code": "995072685",
"telephone_number": "909-342-3009"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9138 ARLON ST STE B4",
"city": "ANCHORAGE",
"state": "AK",
"postal_code": "995073876",
"telephone_number": "907-333-6666"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIM",
"first_name": "JONGGUON",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2016-09-29",
"last_updated": "2016-09-29",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "AK",
"license": "115372",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Anchorage, AK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.