Active NPI
Young Hee Kim, DMD
- General Practice Dentistry
- Aurora, IL
National Provider Identifier
1679748073
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 019-022694
- Practice address
- 648 N Randall Rd
Aurora, IL 60506-3557 - Phone
- (630) 897-1300
- Fax
- (630) 897-7172
- NPI assigned
- Apr 25, 2008
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 019-022694 | IL | Primary |
Addresses
Primary practice location
648 N Randall Rd
Aurora, IL 60506-3557
Mailing address
648 N Randall Rd
Aurora, IL 60506-3557
Phone (630) 897-1300
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 |
|---|---|---|---|
| 019-022694 | IL | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lincolnway Dental Center, PC | General Practice | Past | Accepting new patients |
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 and National Provider Directory roles.
-
- General Practice Dentistry
- North Aurora, IL
- NPI 1801963558
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1209081600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1605139200000",
"number": "1679748073",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "648 N RANDALL RD",
"city": "AURORA",
"state": "IL",
"postal_code": "605063557",
"telephone_number": "630-897-1300",
"fax_number": "630-897-7172"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "648 N RANDALL RD",
"city": "AURORA",
"state": "IL",
"postal_code": "605063557",
"telephone_number": "630-897-1300",
"fax_number": "630-897-7172"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIM",
"first_name": "YOUNG",
"middle_name": "HEE",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-04-25",
"last_updated": "2020-11-12",
"certification_date": "2020-10-12",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "IL",
"license": "019-022694",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Aurora, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.