Individual provider Active NPI

Young Eun Kim, DDS

  • General Practice Dentistry
  • Carmel, IN
National Provider Identifier
1689946576
Registry record updated Feb 7, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
12011761A Issued in IN
Practice address
10485 N Michigan Rd
Carmel, IN 46032-7942
Phone
(317) 875-7645
NPI assigned
Feb 7, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 7, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 12011761A IN Primary

Addresses

Primary practice location

10485 N Michigan Rd
Carmel, IN 46032-7942

Mailing address

10485 N Michigan Rd
Carmel, IN 46032-7942
Phone (317) 875-7645

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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

Enrollment IDStateProvider typePAC IDDetails
I20161206002417 IN Order and Referring Only - DentistPractitioner - Dentist 1658651716

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
12011761AINMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
JMH Dental LLC 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.

NPI Registry JSON

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

{
    "created_epoch": "1328572800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1328572800000",
    "number": "1689946576",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10485 N MICHIGAN RD",
            "city": "CARMEL",
            "state": "IN",
            "postal_code": "460327942",
            "telephone_number": "317-875-7645"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10485 N MICHIGAN RD",
            "city": "CARMEL",
            "state": "IN",
            "postal_code": "460327942",
            "telephone_number": "317-875-7645"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "YOUNG EUN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-02-07",
        "last_updated": "2012-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IN",
            "license": "12011761A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Carmel, IN

Sources for this page

Verify at the official NPI Registry.