Kyung Hoon Kim, D.M.D

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

DS042142 Issued in PA

Practice address

545 W Main St Ste 11
Trappe, PA 19426-1981

Phone

(484) 200-7355

NPI assigned

Jun 17, 2015

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in PA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Amdent LTD.

  • Dentist
  • Wyomissing, PA
  • NPI 1386673432
  Medicare reassignment NPD
• Amdent LTD

  • Dentist
  • Hamburg, PA
  • NPI 1710256938
  NPD
• Amdent LTD

  • Dentist
  • Sinking Spring, PA
  • NPI 1912276130
  NPD
• Amdent LTD

  • General Practice Dentistry
  • Trappe, PA
  • NPI 1184129603
  NPD (past)

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

{
    "created_epoch": "1434499200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698192000000",
    "number": "1679954432",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 JACOB WAY",
            "city": "COLLEGEVILLE",
            "state": "PA",
            "postal_code": "194262527",
            "telephone_number": "215-350-8242"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "545 W MAIN ST STE 11",
            "city": "TRAPPE",
            "state": "PA",
            "postal_code": "194261981",
            "telephone_number": "484-200-7355"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6 Oriole Ave",
            "address_purpose": "LOCATION",
            "city": "Media",
            "state": "PA",
            "postal_code": "190634515",
            "country_code": "US",
            "telephone_number": "610-891-0940",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KIM",
        "first_name": "KYUNG HOON",
        "name_prefix": "Dr.",
        "credential": "D.M.D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-06-17",
        "last_updated": "2023-10-25",
        "certification_date": "2023-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "VA",
            "license": "0401418148",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "MD",
            "license": "17731",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "PA",
            "license": "DS042142",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Home Choice Companion Care
• JHB Therapy, LLC
• John Johnson
• Cynthia Gross Keating, MS, OTR/L
• Jon A. Keim, MD
• Kyle Brandon Klim, DC
• Soo S. Lee, D.M.D.
• Levillecare Solutions LLC
• Tressa Mary Malikkal, O.D.
• Emily Martin

• Oral and Maxillofacial Surgery (Dentist) in Trappe, PA
• Providers in Trappe, PA by specialty
• Oral and Maxillofacial Surgery (Dentist) in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 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.

Verify at the official NPI Registry.